内窥镜下经鼻筛窦入路切除前颅底肿瘤的应用解剖学研究

发布时间：2018-06-19 00:46

本文选题：筛窦/解剖学和组织学 + 颅底肿瘤/外科学　；参考：《安徽医科大学学报》2008年06期

【摘要】：目的探讨鼻内窥镜相关的鼻窦前颅底区域应用解剖学,为鼻内窥镜前颅底手术提供解剖学参考。方法10具(20侧)成人湿尸头标本按照Messerklinger术式开放前后组筛窦,暴露并磨开前颅底,并对涉及的结构进行鼻内窥镜解剖学观察、测量和拍照。选15例临床垂体腺瘤患者头颅CT导航数据导航下进行该入路相关的骨性结构测量。结果鼻小柱基点及基线与各解剖结构的平均距离和夹角分别为:筛前动脉58mm±4.0mm,52.0°±5.5°;筛后动脉65.8mm±3.5mm,41.5°±3.5°;筛板中部53.4mm±3.6mm,50.0°±4.5°;蝶筛交界处68.2mm±5.5mm,38.5°±3.5°;视神经管颅口76.4mm±3.3mm,33.5°±5.5;两侧眶内侧壁之间距离22.4mm±4.5mm;两侧视神经管颅口之间的距离17.3mm±2.4mm;额窦口与鞍结节之间的距离40.3mm±3.6mm。结论内窥镜下经鼻筛窦入路可以完全在内窥镜下比较容易到达前颅底区域,能够很好地暴露两侧眶内侧壁之间前达额窦口和后达蝶鞍的前颅底区域,能够充分显露和切除前颅底肿瘤。
[Abstract]:Objective to study the applied anatomy of the anterior skull base region of the nasal sinus associated with nasal endoscope, and to provide anatomic reference for the anterior skull base surgery under the nasal endoscope. Methods 10 adult wet cadavers were exposed and ground to the anterior skull base according to Messerklinger's method of opening ethmoid sinus before and after opening, and the structures involved were observed, measured and photographed by nasal endoscope. The bone structure related to this approach was measured in 15 patients with pituitary adenoma under the guidance of CT navigation data. Results the average distance and angle between base point and baseline of nasal column and anatomical structure were: anterior ethmoidal artery (58mm 卤4.0 mm) 52.0 掳卤5.5 掳, posterior ethmoidal artery (65.8mm 卤3.5 mm) 41.5 掳卤3.5 掳, median ethmoid plate (53.4mm 卤3.6 mm) 50.0 掳卤4.5 掳, sphenoethmoid junction (68.2mm 卤5.5 卤3.5 掳), cranial orifice of optic canal (76.4mm 卤3.3 mm) 33.5 掳卤5.5 掳, distance between bilateral medial side and orbital wall (22.4mm 卤4.5 mm). The distance between cranial orifice and frontal sinus orifice was 17.3mm 卤2.4 mm, and the distance between frontal sinus orifice and Sellar tubercle was 40.3mm 卤3.6 mm. Conclusion the transnasal ethmoid approach under endoscope can easily reach the anterior skull base area and expose the anterior skull base region between the bilateral medial orbital walls to the frontal sinus orifice and the posterior Sella turcica. The tumors of the anterior skull base can be fully exposed and resected.
【作者单位】：安徽医科大学第一附属医院神经外科;中国医学科学院肿瘤医院神经外科;
【基金】：安徽高校省级自然科学研究项目(编号:KJ2008B290) 安徽省科技攻关计划项目(编号:08010302192)
【分类号】：R322.31

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