关键词: 经鼻蝶入路, 斜坡区, 术前评价, CT

Abstract:

Objective　The aim of this study was to evaluate the relationship between the sphenoid sinus and clivus with CT, serving to provide an anatomic basis for design of a transsphenoidal approach to the clival region.　Methods　A total of 30 patients underwent thin-layer head scan with 64-slice spiral CT, the sagittal images were reconstructed in AW 4.2 workspace. The incidence of the clival recess, the area of the sphenoid sinus, the thickness and height of the clivus behind the sphenoid sinus, and the relationship between them were analysed in the midsagittal plane.　Results　The thickness of clivus in 73% of patients was less than 6.0 mm, while the height of the clivus was more than 9.0 mm. The incidence of the clival recess was 63%. When the clival recess was present, the thickness of clivus was (1.8±1.1)mm; The thickness of clivus was less than 6.0 mm in 10% of patients with no clival recess. There was negative linear correlation between the area of the sphenoid sinus and the thickness of the clivus. The thickness of clivus in 17% of patients was more than 6.0 mm, while the area of the sphenoid sinus was more than 3 cm2.　Conclusion　The assessment of thickness of the clivus and the clival recess with CT is useful in designing the individualized transsphenoidal approach to the clival region.

Key words: Transsphenoidal approach, Clival region, Preoperative evaluation, CT