Anatomical study of unilateral endoscopic endonasal transsphenoidal approach for sellar operation
10.3760/cma.j.issn.1671-8925.2009.04.012
- VernacularTitle:内镜下经单鼻孔蝶窦人路鞍区手术的解剖研究
- Author:
Song-Tao QI
1
;
Hong-Hai LUO
;
Yu-Ping PENG
Author Information
1. 南方医科大学南方医院
- Keywords:
Neuroendoseope;
Single-nostril transsphenoidal approach;
Endoscopic anatomy
- From:
Chinese Journal of Neuromedicine
2009;8(4):372-375,379
- CountryChina
- Language:Chinese
-
Abstract:
Objective To study the identification of the endoscopic anatomical landmarks in the unilateral endoscopic endonasal transsphenoidal approach, and discuss the verification of the anterior wall of the sphenoid sinus and expansion of the bone exposure of the sellar region according to different growth patterns of the selhr tumors. Methods Ten formalin-fixed adult cadaveric heads and 5 fresh cadaveric heads wefe perfused with red silicone through the internal carotid artery.and blue glass cement was perfused through the internal jugular vein.The endoscope Was introduced through the unilateral nasal cavity, and the contralateral nasal cavity was fully exposed by removing the superficial nasofacial structures for observation and measurement. Results The distance from the phatyngopalatine arch to the inferior edge of the sphenoidal ostium Was 15.13±1.99 mm,and that from the inferior edge of the posterior middle turbinate to the center of the sellar floor Was 10.20±0.15 mm.The content of the sphenoid sinus Was 8.73±2.90 mL after removal ofthe compartment of the sphenoid sinus,with the sellar floor thickness of 3.68±1.96 mm.The angles between the nasal septurn and the anterior wall of the sphenoid sinus varied significantly on different planes(P＜0.05).Conclusion When difficult to locate the sphenoidal ostium,the opening site can be determined by observing the peculiar oval protuberance on the anterior wall of the sphenoid sinus.the relationship between the anterior wall of the sphenoid sinus and the middle turbinate,and the average distance from the superior limit of the pharyngopalatine arch to the sphenoidal ostiam.The voger on the midline position can be used as the landmark of the midline of the sellar floor.When the tumor has an extrasellar portion,as in the planum sphenoidale,the modified enlarged approach can be the choice.
