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目的研究扩大经蝶窦入路颈内动脉海绵窦段的显微镜及内镜下的解剖特点。方法在10具动静脉灌注染料的成人新鲜尸头上模拟扩大经蝶窦手术入路,在显微镜及内镜下观察颈内动脉海绵窦段的走行特点,及颈内动脉海绵窦段与垂体的关系,测量双侧颈内动脉海绵窦段在不同水平的距离。结果颈内动脉海绵窦段分为5段,有3个动脉分支,其在蝶窦外侧壁上形成颈内动脉隆突,与视神经隆突形成视神经-颈动脉凹陷,是内镜手术中确定中线的标志。颈内动脉前曲段的内侧缘距垂体中线的距离为(11.94±1.90)mm(9.02～14.86mm),后曲段的内侧缘距垂体中线的平均距离为(7.96±2.07)mm(5.64～11.58mm)。结论颈内动脉海绵窦段是扩大经蝶窦手术入路中最重要的解剖结构。内镜下扩大经蝶窦手术可清晰显示海绵窦内的颈内动脉及其分支血管和神经等重要的组织结构,是处理由鞍内侵犯海绵窦内侧壁病变的良好手术方式。
Objective To investigate the anatomic features of the cavernous sinus segment of the internal carotid artery expanding through the transsphenoidal approach by means of microscopy and endoscopy. Methods In 10 adult fresh cadaver heads with arteriovenous perfusion dye, we enlarged the course of transsphenoidal surgery and observed the characteristics of Cavernous sinus segment of internal carotid artery under microscope and endoscope. The cavernous segment of carotid artery and pituitary Relationship, measurement of bilateral internal carotid cavernous sinus at different levels of distance. Results The cavernous sinus segment of internal carotid artery was divided into 5 segments and 3 branches of arteries, which formed carotid artery carina in the lateral wall of sphenoid sinus and formed the optic nerve-carotid artery recess with optic nerve protrusion. symbols of. The distance between the medial edge of the anterior segment of internal carotid artery and the midline of pituitary was (11.94 ± 1.90) mm (9.02 ~ 14.86mm). The average distance between medial edge of posterior segment and pituitary midline was (7.96 ± 2.07) mm (5.64 ~ 11.58mm). Conclusions The cavernous sinus segment of internal carotid artery is the most important anatomical structure for the expansion of transsphenoidal approach. Endoscopic enlargement of the transsphenoidal surgery can clearly show the internal carotid artery and its branches of blood vessels and nerves and other important organizational structures, is to deal with by the saddle inside the cavernous sinus invasion of the wall of a good surgical approach.