鼻至斜坡区解剖特点及经扩大的鼻入路切除斜坡区肿瘤的可行性与安全性

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Abstract Objective To study the key anatomical landmarks and the relationship used in surgical approach from nasal cavity to ventral slope by extended endoscopy. Combined with 2 cases of sellar tumors, the clinical application of the surgical approach in ventral slope was explored. Methods Ten formalin-fixed specimens of head were used to observe the key anatomical landmarks from nasal cavity to ventral slope with anatomical microscope, and established surgical mark. Five fresh specimens of head were used to do along the endoscopic nasal approach. Two cases of tumor invasion slope were used to observe anatomical characteristics of tumor and surgical results by expanded endonasal endoscopic and image data.Results Marking points in the middle line of surgical approach from nasal cavity to ventral slope were as follows: the middle turbinate, choanal , pharyngeal mouth, nasopharynx mucosa , bilateral sphenoid mouth, head length and longus muscle , pharyngeal tubercle , the midpoint of the leading edge of the foramen magnum and so on. To expose the ventral region of middle-lower part of clivus completely, the ranges of stripping the inferior wall of sphenoid sinus and the lower clivus were bounded by pterygoid canal and foramen lacerum, and the distances from the median line were(9.25±0.26)mm and(9.19±0.27)mm, respectively. Simulating surgeries under endoscopy proved the facticity was equal to the real operation. The tumor in 2 cases was completely removed without serious complications after postoperative and follow-up period.Conclusions Extended endoscopic nasal approach can directly reach the clivus, remove tumor safely and keep away the important neurovascular structures and avoid traction of brain.

Key words： endoscope endonasal approach clivus anatomy

Received: 11 March 2015

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	TIAN Xiguang
	ZHAN Shengquan
	DING Zihai

Cite this article:

TIAN Xiguang,ZHAN Shengquan,DING Zihai. Extended endoscopic endonasal approach to ventral part of clival region: an anatomic study and clinical application[J]. Med. J. Chin. Peop. Armed Poli. Forc., 2016, 27(2): 161-166.

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http://journal08.magtechjournal.com/Jwk_wjyx/EN/ OR http://journal08.magtechjournal.com/Jwk_wjyx/EN/Y2016/V27/I2/161

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