目的 探索内镜经眉弓上锁孔入路暴露颅底中线区域的解剖结构，为临床该术式切除颅底中线区域肿瘤提供解剖学基础。 方法 内镜经眉弓上锁孔入路解剖5具成人尸头标本，观察该入路暴露的颅底中线区域脑组织、血管及神经。 结果 内镜经眉弓上锁孔入路可充分暴露前床突及其内侧前颅底硬脑膜、嗅沟及嗅神经；蝶鞍区可显露视神经、视交叉、视交叉前间隙、垂体上动脉、眼动脉、颈内动脉及其周围间隙；上斜坡区域可显露鞍背硬脑膜、乳头体、基底动脉末端、小脑上动脉、大脑后动脉、后交通动脉、动眼神经、滑车神经、三叉神经、面神经、前庭蜗神经及脑桥腹侧。 结论 内镜经眉弓上锁孔入路切除颅底中线区域肿瘤在解剖学上可行，临床上可作为常规显微镜手术及经鼻内镜入路手术的有效补充。
Abstract
Objective To explore the anatomical structures locating at the middle area of skull base exposed by endoscopic supraorbital keyhole approach, so as to provide reference for clinical resection of tumors in the middle area of skull base. Methods The brain tissues, blood vessels and nerves locating at the middle line area of skull base exposed by endoscopic supraorbital keyhole approach were observed in five formalin fixed adult cadaveric heads. Results Through endoscopic supraorbital keyhole approach, the anterior clinoid process and its medial dura of anterior skull base, olfactory groove and olfactory nerve can be clearly exposed in anterior skull base. Optic nerves, optic chiasm, preoptic chiasm space, superior hypophyseal artery, ophthalmic artery, internal carotid artery and its surrounding space can be exposed in sellar region. The dorsum sellar dura, mastoid body, terminal basilar artery, superior cerebellar artery, posterior cerebral artery, posterior communicating artery, oculomotor nerve, trochlear nerve, trigeminal nerve, facial nerve, vestibular cochlear nerve and ventral pons can be exposed in upper clivus region. Conclusions It is feasible to resect tumors in the midline area of skull base using endoscopic supraorbital keyhole approach, and this approach is an effective supplement to conventional microscope approach and nasal endoscopic transnasal approach in the resection of tumors in midline area of skull base.
关键词
内镜 /
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解剖 /
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手术 /
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肿瘤 /
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眶上锁孔入路
Key words
Endoscopy /
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Anatomy /
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Surgery /
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Tumor /
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Supraorbital keyhole approach
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参考文献
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基金
广西科技基地和人才专项（桂科AD18281055）；广西医疗卫生适宜技术开发与推广应用项目（S2019047）
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