内镜下扩大经鼻入路至鞍上池的解剖学特点

The Anatomic Characteristics of the Endoscopic Extended Transnasal Approach to the Suprasellar Cistern

摘要: 目的：观察内镜下扩大经鼻入路至鞍上池的解剖标志，为内镜下进行该入路手术提供解剖学依据。方法：选择5具经过甲醛固定的成人尸头标本，模拟扩大经鼻入路至鞍上池，进行相关解剖学结构观察。结果：鞍上池位于蝶鞍上方，蝶骨平台、鞍结节、鞍底、神经管隆起、颈内动脉海绵窦段、颈内动脉斜坡段等为骨性解剖标志，观察鞍上池骨性结构，磨除鞍底骨质，显露硬脑膜，沿中线打开颅底硬脑膜，观察硬膜下颅内各结构，额叶、前交通动脉、大脑前动脉、视交叉池、视神经、垂体上动脉、垂体、垂体柄、桥脑等为鞍上池内解剖标志。结论：明确了内镜下扩大经鼻入路至鞍上池的解剖学标志，可根据相关解剖学结构标志进行该入路手术。

Abstract: Objective: To observe the anatomical marks of the extended endoscopic transnasal approach to su-prasellar cisterna, and to provide anatomical basis for endoscopic operation of this approach. Methods: Five adult cadaveric head specimens fixed by formaldehyde were selected, the extended transnasal approach to the suprasellar cistern was simulated, and the related anatomical struc-tures were observed. Results: The suprasellar cistern is located above the sella turcica. The planum sphenoidale, the tuberculum sellae, the sellar floor, the optic canal, the cavernous segment of in-ternal carotid artery, and the Clivus segment of internal carotid artery are the bony anatomical marks. Observe the bony structures of the suprasellar cistern, remove the bone, expose the dura, and open the dura mater of the skull base along the midline to observe the structures of the sub-dural intracranial. The frontal lobe, anterior communicating artery, anterior cerebral artery, optic chiasmatic cistern, optic nerve, pituitary gland, pituitary stalk and pons are the anatomical markers in the suprasellar cistern. Conclusions: The anatomic landmarks of the endoscopic extended trans-nasal approach to the Suprasellar cistern are clearly defined, and the approach can be performed according to the relevant anatomical structure marks.