›› 2009, Vol. 40 ›› Issue (6): 984-987.doi: 10.3969/j.issn.0529-1356.2009.06.027

• 论著 • 上一篇    下一篇

经穹隆间第三脑室底锁孔入路的显微解剖

朱玉辐1;兰青2*   

  1. 1.徐州医学院附属医院神经外科, 徐州 221002; 2.苏州大学第二附属医院神经外科,苏州 215004
  • 收稿日期:2008-09-22 修回日期:2009-04-27 出版日期:2009-12-06
  • 通讯作者: 兰青

Microsurgical anatomic studies of interforniceal diaterma keyhole approach to interpeduncular cistern

  1. 1. Department of Neurosurgery, Affiliated Hospital of Xuzhou Medical College, Xuzhou 221002 China; 2. Department of Neurosurgery, Second Affiliated Hospital of Soochow University, Suzhou 215004 China
  • Received:2008-09-22 Revised:2009-04-27 Online:2009-12-06
  • Contact: LAN Qing

关键词: 锁孔入路, 基底动脉, 动脉瘤, 显微解剖,

Abstract: Objective To explore the feasibility and operation methods of interforniceal diaterma keyhole approach for operative therapy of apex basilar artery aneurysm. Methods Interforniceal diaterma keyhole approach was designed to interpeduncular cistern with diaterma incision from tuber cinereum to posterior perforated substance and between bilateral mammillary bodies. The simulation operations of interforniceal diaterma keyhole approach were performed in 16 cadaveric heads by assisting with Stryker neuronavigation. Anatomic structures were observed by surgical microscope and measured by Stryker neuronavigation in the keyhole approach operations. Results The operations of interforniceal diaterma keyhole approach could be accomplished successfully in 16 cadaveric heads. The distances from bregma to superior margin of interventricular foramen, superior margin of adhaesio interthalamica, mammillary body, superior margin of aqueduct of midbrain and bifurcation of basilar artery were (68.4±4.6)mm, (66.3±6.0)mm,(86.3±5.3)mm, (82.0±7.6)mm and (91.8±5.0)mm respectively. The length of surgical window of diaterma was (9.5±2.6)mm from tuber cinereum to posterior perforated substance between bilateral mamillary bodies. The apex of basilar artery, P1 and P2 of posterior cerebral artery, superior cerebellar artery, posterior communicating artery and perforating branches from them could be exposed distinctly in interpeduncular cistern. The scope of operative exposure region was front to clivus and dorsum sellae by dissected the Liliequist panniculus, lateral to oculomotor nerve and posterior to interpeduncular fossa. The bifurcation of basilar artery apex was deviation to left in 68.8%. The bilateral posterior cerebral arteries were oblique to the anterolateral in 68.8%. There were 1-4 perforating branches from the apex of basilar artery in the included angle of bilateral posterior cerebral arteries. Conclusion Interforniceal diaterma keyho

Key words: Keyhole approach, Basilar artery, Aneurysm, Microanatomy, Human

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