【摘要】 目的探讨内镜下枕叶下经天幕入路的解剖通路及操作技巧,为临床神经内镜下松果体区手术操作提供应用解剖基础。方法随机选取10%甲醛固定的国人成年尸体头颅标本15例,在神经内镜下模拟枕叶下经天幕入路,观察各种不同静脉间隙下此手术入路中松果体区解剖结构暴露范围与内镜可调整程度,测量其手术入路相关解剖结构数据。结果模拟枕叶下经天幕入路中,天幕切开后内镜视野及角度调整宽松灵活,松果体区解剖结构显露清楚,手术操作方便。结论枕叶下经天幕入路中,内镜下第Ⅲ间隙同侧血管解剖结构暴露良好,天幕切开可改善内镜调整及对侧解剖暴露,该手术入路可作为内镜下松果体区主要手术入路,第Ⅲ间隙可作为此手术入路主要间隙。更多还原

【Abstract】 Objective To investigate neuroendoscopic anatomy passage and surgical tips of suboccipital transtentorial approach,and supply anatomic application fundamentals for neuroendoscope-assisted operation of pineal region.Methods Fifteen specimens of Chinese adult cadaveric head were selected randomly to simulate neuroendoscope-assisted microneurosurgery approach including suboccipital transtentorial approach.We observed the anatomic structure extention of pineal region of this approach in different gaps,and measured the data of approach and related anatomic structure.Results In simulating operation through suboccipital transtentorial approach,the regulation of neuroendoscopy was flexible.Both lateral anatomic structure of pineal region were exposed clearly with dissection of tentorium,which made operation easily.Conclusion With neuroendosopic suboccipital transtentorial approach,lateral vascular anatomic structure of pineal region is exposed clearly through gap Ⅲ.Dissection of tentorium can improve the regulation of neuroendoscopy and exposition of contralateral anatomic structure.Neuroendosopic suboccipital transtentorial approach can be mainly performed in surgical operation of pineal region.Gap Ⅲ can be mainly used in this approach.更多还原