【摘要】 目的应用神经导航量化观察前、后床突磨除后解剖显露的变化,探讨床突磨除的适应证。方法彩色乳胶灌注4个尸头标本(8侧),模拟翼点开颅,在显微镜下磨除前、后床突,以无框架的立体定向导航设备测量前、后床突磨除前、后视神经、颈内动脉显露长度,颈内动脉视神经间隙,颈内动脉动眼神经间隙的宽度,以及基底动脉的长度,进行分析比较。结果前床突磨除后,视神经及颈内动脉显露长度,视神经颈内动脉间隙宽度,颈内动脉动眼神经间隙的宽度(前方、后方)均较磨除前差异均有统计学意义(均<0.05)。后床突磨除前基底动脉显露长度为(4.0±1.3)mm,磨除后为(6.8±1.1)mm,差异有统计学意义(<0.05)。结论床突磨除可以增加视神经、颈内动脉、基底动脉、颈内动脉视神经间隙及颈内动脉动眼神经间隙的显露,可以应用于床突旁、鞍旁、海绵窦区域和基底动脉上段的手术。更多还原

【Abstract】 Objective To quantitatively assess the microanatomic exposure of anterior and posterior clinoidectomy on a cadaver model by using a neuronavigation system and explore it’s application.Methods Four cadaveric heads(Eight sides) injected with colored latex were used.Simulate pterional craniotomy were performed,and then anterior and posterior clinoid were drilled step by step.A frameless stereotactic navigation device was used to measure the ex-posure of optic nerve,internal carotid artery,basilar artery,the optic-carotid window and the carotid-oculomotor win-dow.The differences of exposure between before and after clinoidectomy were compared.Results After anterior clinoidectomy,the exposed length of optic nerve and carotid artery increased(11.4±1.8) mm and(3.9±2.1) mm,re-spectively;and the exposed width of the optic-carotid window,anterior and posterior carotid-oculomotor window in-creased(7.1±1.7) mm,(2.6±0.9) mm and(3.5±1.6) mm,respectively.After posterior clinoidectomy,the exposed len-gth of basilar artery increased(2.8±1.5) mm.There were significant differences were observed between before and after clinoidectomy(< 0.05).Conclusions Clinoidectomy can increase the exposure of optic nerve,internal ca-rotid artery,basilar artery,the optic-carotid window and the carotid-oculomotor window;and it can be applied to les-ions located in paraclinoid,parasella,cavernous sinu and upper basilar artery.更多还原