摘要
目的探讨内镜辅助眶上锁孔入路治疗垂体瘤的可行性。方法21例福尔马林固定尸体头部标本用于鞍区各解剖结构,特别是垂体柄、视神经、视交叉及其供血动脉特点的观察,总结手术可利用的间隙、应保护的结构;在9例新鲜尸头上模拟进行内镜辅助眶上锁孔入路手术,进一步验证其可行性及优势。结果颈内动脉床突上段长度14.5±1.3mm(8.1～18.5mm),发向垂体柄、视神经或视交叉的穿支动脉的支数分别为:大脑前或前交通动脉3.0支(2～6支),颈内动脉2.1支(1～5支),后交通动脉3.2支(3～6支),基底动脉1.4支(1～3支)。视神经颅内段长度为11.4±2.7mm(6.1～17.6mm),第1间隙面积为44.8±3.4mm2(7.0～100.8mm2),手术可通过第1间隙或(和)第2间隙进行。结论通过眶上锁孔入路治疗向鞍上发展的垂体瘤有充足的操作空间,具有视神经、视交叉减压充分,利于保护其供血动脉的优点。
Objective To discuss the feasibility of supraobital keyhole approach in treating pitu itary adenoma.Method21adult cadaveric heads fixed in formalin were used for dissection,the rela tionship and the feeding arteries of the fatal structures such as pituitary stalk,optic chiasm and optic nerves were studied,the interspaces for operation were recorded.Endoscope-assisted supraorbital keyhole ap proach was performed in9fresh cadaveric heads to verify the feasibility.Result The length of the supr aclinoid internal carotid artery is14.5±1.3mm(8.1～18.5mm),the number of the feeding arteries to pi tuitary stalk,optic nerve and optic chiasm is3.0(2～6)from ACA or ACoA,2.1(1～5)from ICA,3.2(3～6)from PcoA and1.4(1～3)from BA respectively.The intracranial length of optic nerve is11.4±2.7mm(6.1～17.6mm),the aerometer of the first interspace is44.8±3.4mm 2 (7.0～100.8mm 2 ),The opera tion can be performed through the first or?and the second interspace.Conclusion The supraorbital keyhole approach has the advantages in treating pituitary adenoma:a wide working space,decompressing the optic nerve and the optic chiasm drastically with protection of their feeding arteries.[
出处
《中华神经外科杂志》
CSCD
北大核心
2003年第6期414-417,共4页
Chinese Journal of Neurosurgery
关键词
内镜
眶上锁孔入路
手术治疗
垂体瘤
解剖学
Supraorbital keyhole approach
Pituitary adenoma
Anatomy
Endoscope
