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目的:探讨MicronTracker双目视觉导航仪在经鼻内镜颅底手术中解剖数据实时采集的可行性;为经鼻内镜颅底手术提供解剖学依据。方法:在MicronTracker双目视觉导航仪的基础上研制成功经鼻内镜手术解剖数据实时采集系统,测量67具(男32具,女35具)干颅骨相关平面及各解剖结构之间的角度和距离,并行统计学处理。结果:①经鼻内镜手术解剖数据实时采集系统运行稳定,可实时读取探针的俯仰角、方向角和针尖所及任意两点的距离。②测得主要解剖标志数据如下:额骨平面与法兰克福平面夹角男女分别为(77.7±4.7)°和(81.6±4.5)°;额骨平面与鼻底平面夹角男女分别为(78.6±5.8)°和(82.0±4.5)°。同侧鼻棘侧缘到破裂孔前缘,俯仰角男女分别为(61.3±7.6)°和(65.6±7.1)°,方向角男女分别为(7.0±2.6)°和(7.1±1.8)°,距离男女分别为(68.9±4.1)mm和(66.3±3.9)mm;同侧鼻棘侧缘到蝶窦开口,俯仰角男女分别为(40.5±9.3)°和(46.4±6.8)°,方向角男女分别为(2.1±1.8)°和(3.6±2.6)°,距离男女分别为(56.2±3.1)mm和(53.4±3.0)mm。结论:①基于MicronTracker双目视觉导航仪的鼻内镜手术实时解剖数据采集系统可实现解剖标志的快速空间定位及记录。②额骨平面和正中矢状面与鼻腔及颅底结构空间关系恒定,可作为确定鼻腔、前颅底解剖标志空间定位的基准平面。
Objective: To explore the feasibility of MicronTracker binocular vision navigator in real-time acquisition of endoscopic skull base surgery and to provide anatomic evidence for transnasal endoscopic skull base surgery. Methods: Based on the MicronTracker binocular vision navigator, a real-time acquisition system of endoscopic endoscopic anatomy data was developed and the relationship between the relative planes and the anatomical structures of 67 cranial skulls (32 males and 35 females) and Distance, parallel statistical processing. Results: (1) The real-time acquisition system of endoscopic dissection data was stable and could read the probe’s pitch angle, direction angle and the distance between any two points at any time. (2) The data of the main anatomical landmarks were as follows: the male and female angle between frontal plane and Frankfurt plane were (77.7 ± 4.7) ° and (81.6 ± 4.5) °, respectively; the male and female angle between frontal plane and nasal plane were (78.6 ± 5.8) ) ° and (82.0 ± 4.5) °. The distance between the side edge of the ipsilateral nasal spinous process and the leading edge of the ruptured hole was (61.3 ± 7.6) ° and (65.6 ± 7.1) °, respectively, with a mean of 7.0 ± 2.6 ° and 7.1 ± 1.8 °, respectively, The distance between male and female was (68.9 ± 4.1) mm and (66.3 ± 3.9) mm, respectively. The lateral and lateral nasal spines were (40.5 ± 9.3) and (46.4 ± 6.8) °, respectively, The men and women were (2.1 ± 1.8) ° and (3.6 ± 2.6) °, respectively, and were 56.2 ± 3.1 mm and 53.4 ± 3.0 mm respectively. Conclusion: (1) The real-time anatomical data acquisition system based on MicronTracker binocular vision navigator can realize rapid space location and recording of anatomic landmarks. ② The frontal plane and median sagittal plane have a constant spatial relationship with the nasal cavity and skull base, which can be used as a reference plane to determine the spatial location of nasal and anterior skull base anatomical landmarks.