鞍区显微外科解剖

选用40例成人尸头标本,在手术显微镜下对鞍区周围结构进行了观察。为经额和经蝶两种垂体手术径路提供了有关解剖学依据。主要结果如下:1.视交叉位置,82.5%属正常型,7.5%属后置型,均为经额径路的适应型。但前置型(10%)则不适应于经额径路施术;2.测量了两侧视神经颅内段内侧缘间距及夹角。间距及夹角越小,经额径路越难施行;3.两侧颈内动脉间距以平前床突平面处最窄;4.观察了各海绵间窦。出现率基底窦为100%,前间窦为75%,下间窦为40%后间窦为33.3%。在前、下间窦较大的个体施行经蝶径路可能出现困难。

MICROSURGICAL ANATOMY OF THE SELLAR REGION

40 adult cadavor's head wereused for examination of sellar region.Stru-ctures surrounding sellar region were observ-ed under surgical microscope.Special atten-tion was given to anatomical variationsimportant to the transfrontal and transsphen-oidal surgical approaches.The results areas follows:1)About the position of opticchiasma,82.5% of the cases observed belongto normal type,while 7.5% belong lo post-fixed chiasm.It is easy to be done for pit-uitary operation transfrontally in these twotypes.But in prefixed chiasm(10%),it is di-fficult for pituitary operation transirontally2)The distance between medial margins ofboth optic nerves at the site of internaladitus of optic canal and the angle formedby the line along the medial margin of theoptic nerves was measured.It is disadvanta-geous to do pituitary operation transfronta-lly on patient with small angle and distance3)The distance between internal carotidarteries on both sides was measured.Thenarrowest site lies at the level of theanterior clinoid processes.4)The basilarsinus was found in all cases.Anteriorintercavernous sinus was found in 70% ofthe cases.Inferior intercavernous sinus can beseen in 40% cases.Posterior intercavernoussinus was identified in 33.3% of the casesobserved.There may be some trouble to dopituitary operation by way sphenoid sinuson person with larger anterior and inferiorintercavernous sinuses.