【摘要】 目的:明确松果体区及其毗邻结构的神经内镜下解剖特点,探讨内镜下经幕下小脑上入路的解剖通路及手术操作技巧。方法:随机选取10%福尔马林固定的国人成年尸体头颅标本15例,在神经内镜下模拟幕下小脑上入路,观察松果体区解剖结构暴露范围与可调整程度,测量其手术入路相关解剖结构数据。结果:幕下小脑上入路中,内镜视野呆板固定,可调整性差,松果体区解剖结构显露不良,从而影响手术操作。结论:内镜下单纯利用幕下小脑上入路进入松果体区不可取,适当切除小脑上蚓时,幕下小脑上入路中进入第IV间隙后松果体区各解剖结构暴露良好,但内镜调整难度大,此手术入路可作为辅助手术间隙。更多还原

【Abstract】 Objective:To investigate the neuroendoscopic anatomy of pineal region,discuss anatomy passage and surgical tips of infratentorial supracerebellar approach.Methods:15 specimens of Chinese adult cadaveric head were selected randomly to simulate neuroendoscope-assisted microneurosurgery of infratentorial supracerebellar approach.observe the anatomic structure extention of pineal region,measure data of approach and related anatomic structure.Results:In simulating operation through infratentorial supracerebellar approach,inferior colliculis were exposed not very clearly,the view of this approach was stiffness and fixation,the regulation of endoscopy was difficult.Conclusions:Neuroendosopic infratentorial supracerebellar approach can not be used simplicity to approach pineal region,when upper vermis is dissected partly,anatomic structure of pineal region are observed clearly through Gap IV,but the regulation of endoscopy is difficult,infratentorial supracerebellar approach can be used as assistant operative gap.更多还原