Endoscopy ; Humans ; Skull Base ; anatomy & histology ; surgery

Humans ; Skull Base ; anatomy & histology ; surgery

OBJECTIVESTo study the shape and the structures in the craniocervical junction region (CCJR) and the safety of far lateral approach.

METHODSTen cadaveric heads and 20 skull-base specimens were fixed with 10% formalin, and 4 of the 10 cadaveric heads were sectioned in different plane with the aid of operative microscope. The shape and relation of structures in the CCJR were observed.

RESULTSThe third segment of the vertebral artery(VA) was 21.6(15.3 31.9) mm. An incomplete bony canal was found to be 15% and complete bony canal surrounding the VA to be 5% on the VA groove. The distance of the left and right VA was 14.3a(c)(9.8 15.2) mm on the entry into the dura. The length of the occipital condyle was 26.8(25.1 28.2) mm, with the thickness of its anterior, middle and posterior one-third part was 9.9(9.6 10.6) mm, 11.2(9.2 13.1) mm and 8.6 (8.3 9.0) mm respectively. The distance between the posterior pole of the occipital condyle and the intracranial orifice of the hypoglossal canal was 9.9(8.6 11.4) mm, and between the posterior pole and the extracranial orifice was 16.1(13.5 17.1) mm. The transverse process of the atlas was the most important bony landmark for the approach.

CONCLUSIONSKnowing the shape and relationship of the VA and occipital condyle in the CCJR is helpful in preserving the important structures in far lateral approach to target region.

Humans ; Microsurgery ; Occipital Bone ; anatomy & histology ; Skull ; anatomy & histology ; surgery ; Vertebral Artery ; anatomy & histology

OBJECTIVE: Through the observation and the measurements of the significant anatomical landmark the lateral skull base, to provide anatomical data of clinical location and navigation for surgery at the lateral skull base. METHOD: Significant anatomical landmarks of twenty adult cadaveric heads (40 sides) fixed in 10% formaldehyde and 20 operation cases (20 sides) had been observed and measured. Lateral skull bases of cadaveric heads were numbered from 1st to 40th, while the operation cases were numbered from 1st to 20th. RESULT: The anatomical data was achieved by measuring related anatomical landmark as follows: the distances between the significant landmark of the lateral skull base and the pars neuraxis, vein of the jugular foramen; the areas of trautmann triangle; post labyrinths triangle and the superficial triangle of processus mastoideus; the maximal distance of initiative displacement of facial nerve in the lateral skull base operations. CONCLUSION The data measured at lateral skull base could effectively help operators not only to enlarge the field of vision in operations with security and to avoid the damagement of the important blood vessel and nerves, but also to retain the function of the facial nerve to the utmost.
Adult ; Female ; Humans ; Male ; Mastoid ; anatomy & histology ; Skull Base ; anatomy & histology ; Temporal Bone ; anatomy & histology

OBJECTIVETo explore the essence of acupoints by studying its anatomical characteristics and classification.

METHODSBased on numerous previous anatomic researches of acupoints, an adult male and a female corpses infused with red rubber at the location of acupoints were selected in order to observe the level and sectional anatomy of the acupoints, especially the specificity of the known structural distribution of acupoints.

RESULTS(1) The distribution of acupoints has two primary elements. Firstly, it is neurovascular bundles or connective tissue containing abundant nerves and blood vessels, which has the function of qi and blood infusion. It is considered as the acupoint kernel. Secondly, it is the cleft or the tunnel that formed by bones, muscles or fascia, which is also held as the acupoint shell. Different conditions of the human body can influence the opening and closing of the shell, control as well as regulate the function of the kernel so as to regulate the qi and blood circulation. (2) Based on anatomical characteristics, acupoints can be classified into 3 types: the type of cleft, the type of tunnel, and the terminal type. Points of the cleft and tunnel types can be mainly found in the twelve regular meridians which are composed of the kernel and the shell. The points of terminal type are on the Conception Vessel, the Governor Vessel and auricular point, the superficial fascia is the confluence of cerebro-spinal nerve terminal ramus and its concomitant vessels, and it is the site where the qi and blood of meridians distribute to the body surface.

CONCLUSIONAcupoints is the pore formed by bone, muscle or fascia where neurovascular bundles or connective tissue containing abundant nerves and blood vessels pass through and the position where the terminal branch of cranial and spinal nerves and their accompanying by blood vessels emerge and converge at the supiyeficial layer of central body axis. Acupoints are the nodes and terminal point where the zang-fu organs and meridians and qi and blood infused to body surface.

Acupuncture Points ; Adult ; Connective Tissue ; anatomy & histology ; Female ; Humans ; Male ; Meridians ; Muscles ; anatomy & histology ; Skin ; anatomy & histology ; Skull ; anatomy & histology

OBJECTIVE: To explore the feasibility to measure the anatomy landmarks in the anatomy research, even in the operation by the MicronTracker binocular visual navigation system, and to study the anatomy of the transnasal endoscopic surgery of skull base. METHOD: We designed a new anatomy data collection system based on the MicronTracker binocular visual navigation system to measure and record the anatomy landmarks, and measured the angles and distances between the related planes and the important structures on 67 dry adult cranium specimens (32 male, 35 female). RESULT: 1) The system is reliable, the angles and the distances can be acquired in the real time. 2) The major date of the landmarks was the pitch of the Frankfurt horizontal plane according to the frontal bone plane, male: (77.7 +/- 4.7) degrees, female: (81.6 +/-4.5) degrees; the pitch of the bony nasal floor according to the frontal bone plane, male: (78.6 +/- 5.8) degrees, female: (82.0 +/- 4.5) degrees; from the same side of nasal spine to the anterior edge of foramen lacerum, pitch, male: (61.3 +/- 7.6) degrees, female: (65.6 +/-7.1) degrees, azimuth, male: (7.0 +/- 2.6) degrees, female: (7.1 +/- l.8) degrees, the distance, male: (68.9 +/- 4.1) mm, female: (66.3 +/- 3.9) mm; from the same side of the nasal spine to the aperture of the sphenoidal sinus, pitch, male: (40.5 +/- 9.3) degrees, female: (46.4 +/- 6. 8) degrees, azimuth, male: (2.1 +/- 1.8) degrees, female: (3.6 +/- 2. 6) degrees, the distance, male: (56.2 +/- 3.1) mm, female: (53.4 +/- 3.0) mm. CONCLUSION 1) The anatomy data collection system based on the MicronTracker binocular visual navigation system can be used to measure the anatomy landmarks conveniently, accurately and quickly. 2) The relationship between the landmarks of the skull base and the nasal cavity and the frontal bone plane and the sagittal plane is stable, and the planes can be used as the datum plane to look for the landmarks in the transnasal endoscopic surgery of skull base.
Adult ; Anatomy ; instrumentation ; Endoscopy ; Female ; Humans ; Male ; Nasal Bone ; anatomy & histology ; surgery ; Nasal Cavity ; anatomy & histology ; surgery ; Nose ; anatomy & histology ; surgery ; Skull Base ; anatomy & histology ; surgery

Cranial Fossa, Posterior ; Cranial Sinuses ; anatomy & histology ; Humans ; Skull ; anatomy & histology ; Transillumination

BACKGROUNDDuring craniotomies using the transpetrosal-presigmoid approach, exposure of the sigmoid sinus remains an essential but hazardous step. In such procedures, accurate localization of the anterosuperior point of the transverse-sigmoid sinus junction (ASTS) is very important for reducing surgical morbidity. This study aimed to create an accurate and practical method for identifying the ASTS.

METHODSOn the lateral surfaces of 40 adult skulls (19 male skulls and 21 female skulls), a rectangular coordinate system was defined to measure the x and y coordinates of two points: the ASTS and the squamosal-parietomastoid suture junction (SP). With the coordinate system, the distribution characteristics of the ASTS were statistically analyzed and the differences between the ASTS and SP were investigated.

RESULTSFor ASTS-x, significant differences were found in different sides (P = 0.020); the ASTS-x in male skulls was significantly higher on the right side (P = 0.017); there was no significant difference between the sides in female skulls. There were no significant differences in gender or interaction of gender and side for ASTS-x, and for ASTS-y, there were no significant differences in side, gender, or interaction of gender and side. For both sides combined, the mean ASTS-x was significantly higher than the mean SP-x (P = 0.003) and the mean ASTS-y was significantly higher than the mean SP-y (P = 0.011).

CONCLUSIONSThis reference coordinate system may be an accurate and practical method for identifying the ASTS during presigmoid craniotomy. The SP might be difficult to find during presigmoid craniotomy and, therefore, it is not always a reliable landmark for defining the ASTS.

Adult ; Cranial Sinuses ; anatomy & histology ; Craniotomy ; Female ; Humans ; Male ; Middle Aged ; Skull ; anatomy & histology ; Transverse Sinuses ; anatomy & histology

The clival region refers to the skull base between dorsum sellae and anterior border of foramen magnum. It is located in central area of skull base and is in close proximity to pons, medulla oblongata, basilar artery and other crucial intracranial structures. Although there are various microsurgical approaches using craniotomy to reach this region, there are still a lot of difficulty in exposure of clivus. With the increasing development in extended endoscopic endonasal approach, a new route to clivus, as well as meticulous endoscopic anatomy studies is emerging. This article reviewed related researches progress of the detailed anatomical studies from endoscopic perspective.
Cranial Fossa, Posterior ; anatomy & histology ; Craniotomy ; Endoscopy ; methods ; Humans ; Nasal Surgical Procedures ; methods ; Nose ; anatomy & histology ; Skull Base ; anatomy & histology

OBJECTIVETo provide endoscopic anatomic bony structures of pterygopalatine fossa for skull base surgery.

METHODSThe bony structures of the pterygopalatine fossa were observed in ten dry skulls under endoscope.

RESULTSThe pterygopalatine fossa showed a long and narrow cleft composed of the body and pterygoid process of sphenoid bone, the lamina perpendicular of palatine bone, and the posterior wall of maxillary sinus. The pterygopalatine fossa is (21.4 +/- 0.8) mm x (5.2 +/- 0.3) mm x (3.2 +/- 0.3) mm, with seven paths communicating with nasal cavity, mouth cavity, pharynx, orbit, infratemporal fossa and middle cranial fossa. Under endoscope,the whole pterygopalatine fossa could be observed.

CONCLUSIONSEndoscopic anatomic study of the pterygopalatine fossa is important to endoscopic endonasal skull base surgery. Under endoscope,the whole pterygopalatine fossa can be observed.

Adult ; Anatomy, Regional ; Asian Continental Ancestry Group ; Cranial Fossa, Middle ; anatomy & histology ; surgery ; Endoscopy ; Humans ; Otorhinolaryngologic Surgical Procedures ; Pterygopalatine Fossa ; anatomy & histology ; surgery ; Skull Base ; anatomy & histology ; surgery