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目的:为经穹窿间中间帆锁孔入路提供显微外科解剖基础。方法:导航辅助下在16尸头标本上模拟左、右经穹窿间中间帆锁孔入路手术,显微镜下观察第三脑室、松果体区的手术显露范围,并比较左、右锁骨孔入路对手术显露的影响。结果:导航辅助下经穹窿间中间帆锁孔入路手术能在尸头上顺利完成,可清晰显露乳头体之后的第三脑室后大部,松果体区,显露的最深处为小脑中央小叶与小舌,上界达胼胝体压部下表面。对侧锁孔入路对第三脑室侧壁、松果体区外侧部的手术显露好于同侧锁孔入路。结论:经穹窿间中间帆锁孔入路技术上可行,适用于侵犯第三脑室后部的松果体区中间部肿瘤的手术治疗。
Objective: To provide a microsurgical anatomical basis for the middle sailing keyhole approach. Methods: Navigational aids were used to simulate the left and right intervertebral space between the left and right cadaver trochlear holes in the 16 cadaver specimens. The scope of the operation in the third ventricle and the pineal region was observed under a microscope. The left and right clavicular holes were compared The impact of road on surgical exposure. Results: Navigational aids through the middle of the dome between the middle sailing keyhole surgery can be successfully completed in the cadaver head, the nipple can be clearly revealed after most of the third ventricle, pineal region, revealed the deepest central lobular cerebellar And the tongue, the upper limit of the lower surface of the corpus callosum pressure. Opposite keyhole approach to the third ventricle sidewall, pineal region outside the operation revealed better than ipsilateral keyhole approach. Conclusion: It is technically feasible to approach the middle sailing keyhole through the fornix and is suitable for surgically treating the tumors in the middle part of the pineal region infringing the posterior part of the third ventricle.