摘要
目的 :为临床开展神经内窥镜下经鼻蝶切除垂体腺瘤提供解剖基础。方法 :对 2 5例成人头部固定标本进行蝶鞍区的解剖测量 ,并对 9具新鲜尸头进行内窥镜下经鼻蝶至蝶鞍的解剖观察。结果 :鞍膈高度(5 .5± 0 .6)mm ,鞍膈孔前后径 (6.2± 1.3 )mm ,鞍膈孔左右径 (6.5± 1.5 )mm ,鞍膈孔前缘到鞍结节 (3 .4± 1.3 )mm ,鞍膈孔前缘到垂体柄 (2 .5± 1.1)mm ;视神经出视神经颅口宽 (5 .0± 0 .4)mm ,两侧内缘间距 (13 .7±2 .3 )mm ,视交叉前缘距视神经间沟中点 (6.8± 1.3 )mm ,视交叉宽 (11.5± 1.4)mm。结论 :神经内窥镜下经鼻蝶切除垂体腺瘤应熟悉蝶鞍底及窦内的解剖标志 ,并充分利用鞍膈等解剖结构有序地做肿瘤切除。
Objective: To provide anatomical basis for endoscopic endonasal transsphenoidal surgery for pituitary tumors. Methods: The structures in sellar area were observed and measured in 25 adult cadaveric head specimens, and the structures in sphenoidal sinus and sellar area were observed under the operating endoscope in 9 fresh adult cadaveric head specimens. Results: The height of diaphragma sellea turcica was 5.5±0.6 mm. The sagittal and the transverse diameter of foramen of diaphragma sellea turcica were 6.2±1.3 and 6.5±1.5 mm respectively. The distances from the anterior edge of it to the anterior edge of pituitary stalk and tuberculum sellae were 2.5±1 .1 and 3.4±1.3 mm. At the cranial end, the transverse diameter of optic nerve was 5.0±0.4 mm The distance between bilateral optic nerves was 13.7±2.3 mm. The distance from anterior border of opticochiasma to the midpoint of sulcus prechiasmaticus was 6.8±1.3 mm The transverse diameter of chiasma was 11.5±1.4 mm. Conclusion: Neurosurgeon should be familiar with the structures of sellar area and the bottom of sphenoidal sinus and take advantage of these anatomical landmarks to perform the endoscopic endonasal transsphenoidal pituitary surgery step by step.
出处
《中国临床解剖学杂志》
CSCD
北大核心
2003年第5期419-420,共2页
Chinese Journal of Clinical Anatomy
关键词
垂体腺瘤
神经内窥镜
蝶鞍
应用解剖
pituitary tumor
neuroendoscope
sellar area
applied anatomy
