多模态辅助下经纵裂-胼胝体-透明隔-穹窿间-第三脑室入路的解剖学研究

李玉呈; 陶存山; 王友伟; 曹德茂; 齐文涛; 武永康

doi:10.13418/j.issn.1001-165x.2017.05.004

中国临床解剖学杂志 ›› 2017, Vol. 35 ›› Issue (5) : 494-500. DOI: 10.13418/j.issn.1001-165x.2017.05.004

应用解剖

多模态辅助下经纵裂-胼胝体-透明隔-穹窿间-第三脑室入路的解剖学研究

李玉呈，　陶存山，　王友伟，　曹德茂，　齐文涛，　武永康

作者信息 +

Anatomical study of the approach through interhemispheric fissure - corpus callosum septum - the third ventricle under the multimodal assistance

LI Yu-cheng, TAO Cun-shan, WANG You-wei, CAO De-mao, QI Wen-tao, WU Yong-kang

Author information +

文章历史 +

摘要

目的　研究在导航引导下经纵裂-胼胝体-透明隔-穹窿间-第三脑室的解剖入路，探讨神经导航在优化此入路的操作方法及其具体应用价值。方法　选用5例成人尸头标本，模拟经纵裂-胼胝体-透明隔-穹窿间-第三脑室的入路，并在神经导航下通过神经内镜及显微镜对入路途径中的相关结构进行解剖学观察以及相应数据的测量, 并进行统计学分析。结果　通过将5例标本的标本解剖测量数据与导航上测量数据进行统计学分析，发现其所得P值均大于0.05，这说明标本解剖测量数据与导航上测量数据并无统计学差异，也说明神经导航可以精确指导该入路。结论　导航引导下可以实现对胼胝体的精准切开、对透明隔及穹窿等重要解剖结构的可靠识别和精细操作，优化先前的手术入路，以减轻脑组织损伤，提高手术的可靠性。

Abstract

Objective　To study the anatomical approach of interhemispheric fissure-corpus callosum septum -third ventricle guided by navigation，and explore the method of neuronavigation in optimizing the approach and its application value.　Methods　5 adult cadaveric heads were selected, and to simulate the interhemispheric fissure - corpus callosum septum - the third approach. The relevant structures in the approach pathway were observed under neuronavigation, neuroendoscope and microscopy. The corresponding data were measured and statistically analyzed.　Results　Through the 5 cases of specimen anatomical data and navigation measurement data for statistical analysis, it was found that the P values are greater than 0.05, indicating that the entity from measured data and navigation data had no statistical difference, it also shows that the neuronavigation can guide the approach accurately.　Conclusions　Under the guidance of navigation precise incision of the corpus callosum reliable and precise recognition of septum pellucidum and fornix important anatomic structures, optimization of the previous approach could be achieved so that brain injury could be reduced and operation reliability augmented.

导出引用

李玉呈,陶存山,王友伟,曹德茂,齐文涛,武永康. 多模态辅助下经纵裂-胼胝体-透明隔-穹窿间-第三脑室入路的解剖学研究[J]. 中国临床解剖学杂志. 2017, 35(5): 494-500 https://doi.org/10.13418/j.issn.1001-165x.2017.05.004

LI Yu-cheng, TAO Cun-shan, WANG You-wei, CAO De-mao, QI Wen-tao, WU Yong-kang. Anatomical study of the approach through interhemispheric fissure - corpus callosum septum - the third ventricle under the multimodal assistance[J]. Chinese Journal of Clinical Anatomy. 2017, 35(5): 494-500 https://doi.org/10.13418/j.issn.1001-165x.2017.05.004

参考文献

[1] Widmann G, Schullian P, Ortler M, et al. Frameless stereotactic targeting devices: technical features, targeting errors and clinical results[J]. Int J Med Robot，2012，8(1):1-16.
[2] 李聪慧, 李建华, 张金峰, 等. 经胼胝体-穹隆间入路的内镜解剖学入路[J]. 中国临床解剖学杂志，2009，27（2）：130-133.
[3] 吴春富, 陆　华. 神经内镜下经纵裂胼胝体侧脑室入路的应用解剖[J]. 中国临床解剖学杂志，2011，29 (2): 128-130.
[4] Dandy WE. Diagnosis,localization and removal of tumors of the third ventricle[J].Bull Johns Hopkins Hosp，1922,33:188-189.
[5] Busch E. A new approach for the removal of the third ventricle[J].ActaPsychiatrNeurolScad，1944,19:57-60.
[6] Apuzzo ML, Chikovani OK, Cott PS, et al. Transcallosal approaches for lesions affecting the third ventricle:surgical considerations and consequences[J].Neurosurgery，1982，10(5)：547-554.
[7] Roselfeld JV, Harveey AS, Wrennall J, et al. Transcallosal resection of hypothalamic,with control of seizures,in children with gelastic epilepsy[J].Neurosurgery，2001，48(1):108-118.
[8] Winkler PA, Ilmberger J, Krishnan KG, et al. Transcallosal inter fornicealtransforaminal approach for removing lesions occupying the third ventricle space: Clinical and neuropsychological results[J]. Neumsurgery，2000，46(4)：879-888.
[9] Woiciechowsky C, Vogel S, Lehmann R, et al. Transcallosal removal of lesions affecting the third ventricle: an anatomic and clinical study[J]. Neurosurgery，1995，36(1):117-123.
[10]Winkler PA, Ilmberger J, Krishnan KG, et al. Transcallosalinterforniceal- transforaminal approach for removing lesions occupying the third ventricle space: Clinical and neuropsychological results[J] . Neurosurgery, 2000, 46(4): 879-890.
[11] Hutter B, Spetzger U, Bertalanffy H, et al. Cognition and quality of life in patients after transcallosal microsurgery for midline tumors [J]. J NeurosurgSci, 1997, 41(1): 123-129.
[12]Mazza M, Di Rienzo A, Costagliola C, et al. The interhemispherictranscallosal-transversal approach to the lesions of the anterior and middle third ventricle: Surgical validity and neuropsychological evaluation of the outcome[J]. Brain Cogn, 2004, 55(3): 525-534.
[13]邵毅，杨扬，王建刚，等. 经胼胝体入路手术的改良：胼胝体开窗[J]. 中华神经外科杂志，2007，23(5)：364-368.
[14] Konovalov AN, Gorelyshev S. Surgical treatment of anterior third ventricle tumours[J]. ActaNeurochir (Wien)，1992，118(1-2)：33-39.
[15]Botez-Marquard T, Botez MI. Visual memory deficits after damage to the anterior commissure and right fornix[J]. Arch Neurol, 1992, 49(3):321-324.
[16]Little JR, MacCarty CS.Colloid cysts of the third ventricle[J]. J Neurosurg，1974,40(2),230-235.