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目的为临床经单鼻孔-蝶窦手术入路切除垂体腺瘤提供解剖资料。方法取成人尸头湿标本20例,在显微镜下进行显微解剖观察和测量。结果(1)90%的鞍膈孔大于5 mm,鞍膈平均厚度为(0.18±0.08)mm;(2)85%的蝶窦为全鞍型,85%的蝶窦有中隔,18.8%的蝶窦中隔居中;(3)鞍底厚度平均为(0.81±0.34)mm,70%小于1 mm,15%的鞍底外形为平坦;(4)颈内动脉在蝶窦壁形成隆起占45%,无隆起占55%,隆起位于蝶窦侧壁后上方。视神经管在蝶窦壁形成隆起占72.5%,无隆起占27.5%,隆起位于蝶窦侧壁前上方;(5)前海锦间窦、下海绵间窦和后海绵间窦出现率分别为80%、25%和15%。结论熟悉蝶窦及鞍区解剖结构有助于经单鼻孔-蝶窦手术入路术中安全切除垂体腺瘤。
Objective To provide anatomical data for clinical resection of pituitary adenomas by single nostril surgery. Methods Twenty adult cadaveric wet specimens were obtained and observed under microscope and measured under microscope. Results (1) 90% of the septum holes were larger than 5 mm and the average thickness of the septum was (0.18 ± 0.08) mm. (2) 85% of the sphenoid sinus were whole saddle, 85% (3) The mean thickness of the sella was (0.81 ± 0.34) mm, 70% was less than 1 mm, and the shape of the sella was flat in 15%. (4) The internal carotid artery 45%, no uplift accounted for 55%, uplift in the sphenoid sinus behind the top. Optic nerve canal in the sphenoid sinus wall formation of the protuberance accounted for 72.5%, no uplift accounted for 27.5%, uplift in the sphenoid sinus wall in front of the top; (5) before the sea Kam, the next sponge and posterior sponge sinus sinus rates were 80 %, 25% and 15%. Conclusions Being familiar with anatomical structures of the sphenoid and saddle regions is helpful for safely removing the pituitary adenomas through the single nostril - sphenoid sinus surgery.