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目的模拟在大体形态标本行内镜下经口咽入路行枕骨大孔扩大术的可行性,为临床治疗颅底凹陷症提供一定的解剖学依据。方法选取完整人体头颈部标本20具,将标本随机分为两组,第Ⅰ组10具(男7例、女3例),为传统手术组;第Ⅱ组10具(男7例、女3例),为内镜组。分别进行经口咽入路行枕骨扩大术模拟手术,内镜组采用MED-Ⅱ型手术系统。结果内镜下手术可以达到与传统手术同样的效果,但在咽后壁正中切口的长度和斜坡打磨方面,内镜组更具有优势;逆行法和磨除法均能实现对斜坡的部分切除,为了避免损伤硬脑膜,尽可能选用磨除法。结论内镜下经口咽入路行枕骨大孔扩大术在技术上是可行的,内镜手术组不仅能达到传统手术的扩大范围,而且对局部结构显露更为清晰,操作更为方便和精确,明显优于传统手术组。
Objective To simulate the feasibility of endoscopic orpharyngeal foramen magnification in general morphology specimens and to provide some anatomic evidences for clinical treatment of skull base depression. Methods Totally 20 specimens of human head and neck were selected. The specimens were randomly divided into two groups. Group I (10 males and 7 females, 3 females) were in the traditional surgery group. Group II (10 males and 7 females 3 cases), endoscopic group. Respectively, oropharyngeal line occipital augmentation surgery simulation, endoscopic group using MED-Ⅱ-type surgical system. Results Endoscopic surgery can achieve the same effect as traditional surgery. However, the length of the median posterior pharyngeal incision and the slope polishing, the endoscopic group is more advantageous; retrograde and ablation method can be achieved on the partial removal of the slope, in order to Avoid damaging the dura mater and use a grinding method wherever possible. Conclusions Endoscopic transoral pharyngeal foramen magnification is technically feasible. Endoscopic surgery can not only expand the scope of traditional surgery, but also reveal the local structure more clearly and operate more conveniently and precisely , Significantly better than the traditional surgery group.