扩大经鼻蝶入路海绵窦显微解剖学研究-神经外科学专业毕业论文.docxVIP

扩大经鼻蝶入路海绵窦显微解瓣学研究扩大经鼻蝶入路海绵窦显微解剖学研究 扩大经鼻蝶入路海绵窦显微解瓣学研究 扩大经鼻蝶入路海绵窦显微解剖学研究 中文摘要 目的 研究扩大经鼻蝶入路海绵窦内的显微镜下解割特点，为雅床手术提供形 态学基础。 方法 在?具动赫灌注乳胶的成人尸头上模拟扩大经鼻蝶手术入路，在显微镜 下观察颈内动脉海绵窦段及其分支、展神经和外侧壁内颅神经的解剖关系并进行 测量。 结果 颈内动脉海绵窦段分为5段，有前后膝两大弯曲，有三个分支。鞍结节、 鞍底、斜坡、颈内动脉和视神经骨性隆起是确定手术区域的重要标志。前鼻棘至 蝶窦口、鞍底的平均距离，鞍结节、鞍底平均宽度分别为6．7cm、8．0cm、12。3mm、 18。6潮。两侧颈内动脉、视神经的骨性隆起及隐窝的平均距离分别为18．8姗、 17．4mm、20．7mm。颈内动脉与动眼神经、滑车神经、展神经、眼神经入眶上裂处 的平均距离、与上颌神经入圆孔处的距离分别为3．4mm、3．4mm、3．9mm、4。5mm、 6．8mm。两侧颈内动脉篱后膝部、水平段的平均距离分别为13．5mm、23．6mm、 19．3mm。垂体与颈内动脉前膝部、水平段的平均距离为2．9mm、4．3mm。 结论 颈内动脉海绵窦段数及樱关颅神经是扩大经鼻蝶手术入路的重要解剖结 构，显徽镜下扩大经鼻蝶入路可清晰显示海绵窦内颈内动脉及其分支血管和神经 等重要结构的位置和关系，是处理由鞍内向海绵寞内侵袭病变的良好手术方式。 关键谓 扩大经鼻蝶入路；颈内动脉；海绵窦；解剖学 中国图书资料分类号 R651．1 文献标志码A 扩大经奏蝶入路海绵窦显微解剖学研究英文摘要 扩大经奏蝶入路海绵窦显微解剖学研究 英文摘要 Abs tract The microscopic cavernous sinus surgery via the extended transsphenoidal approach：an anatomic study Objective The microscopic s疆参c砖anatomy of the cavernous via the extended transsphenoidal approach was studied to establish a娃anatomic basis for surgical 缸．eatment． Methods Simulated surgery Was performed on seven adult cadaver heads which perfused by latex via extended transsphenoidal approach。The appearance feature of the cavernous segment of the ICA and its branch vessels and its relationship with cranial nerve were observed under microscope．Some anatomic parameters were measured． Results The cavernous segment ofthe ICA carl be divided into 5 segement and is of 3 vessel branches and 2 bends．The tuberculum sellae，clivus，sellar base，ICA prominence，and optic nerve prominence ale the important bone landmarks to define the surgical area。The average distances from anterior nasal spina to the ostium of sphenoid sinous，sellae base are 6．7cm，8．0cm．The average width of the tuberculum sellae and sellar base are 1 2。3mm，1 8．6mm．The average distances of the ICA prominences，optic nerve prominences，optico—carotid recesses are 18．8mm，17．4mm，20．7mm．The average distances from the lateral edge ofpituitary to the anterior bend，the horizontal part of lCA are 2．9mm，4。3mm．