Lin Y, Qiu Y
Department of Neurosurgery, Shanghai Second Medical, University Affiliated Renji Hospital, Shanghai, PR China.
Minim Invasive Neurosurg. 2003 Jun;46(3):155-60. doi: 10.1055/s-2003-40739.
To make a study of the detailed microanatomy of endoscope-assisted glabellar nasal keyhole approach (GNKA) to be used clinically.
10 dry adult Chinese skulls were measured and 10 perfused cadaveric heads were dissected to mimic the GNKA.
Average distances between bilateral supraorbital foramen/incisure, supratrochlear incisure, medial orbital wall were 47.71+/-3.61 mm, 33.67+/-3.82 mm and 24.34+/-1.29 mm, respectively, in dry skulls. Average distance from nasion to medial inter-canthus line (ICL) was 10.31+/-1.02 mm in cadaveric heads. The nasion was 3.95+/-0.45 mm above the cribriform plate (CP) and the ICL is 6.25+/-0.71 mm below. With the assistance of endoscopes, GNKA can expose all extradural structures near the midline from the anterior skull base to the ventral brain stem corresponding to the clivus. The exposed clival dura was 19.18+/-1.44 mm in width and 25.44+/-1.25 mm in length. Intradural structures such as frontal base, parasellar area, longitudinal fissure and the third ventricle floor, can also be exposed.
GNKA is a minimally invasive and effective anterior skull base approach. Determining the inferior margin of incision by ICL instead of nasion is more convenient and can expose the subcranial area better.
对用于临床的内镜辅助眉间鼻锁孔入路（GNKA）进行详细的显微解剖学研究。
测量10个中国成年干燥颅骨，并解剖10个灌注尸头以模拟GNKA。
在干燥颅骨中，双侧眶上孔/切迹、滑车上切迹、眶内侧壁之间的平均距离分别为47.71±3.61mm、33.67±3.82mm和24.34±1.29mm。在尸头中，鼻根至内眦间线（ICL）的平均距离为10.31±1.02mm。鼻根位于筛板（CP）上方3.95±0.45mm，ICL位于其下方6.25±0.71mm。在内镜辅助下，GNKA可暴露从前颅底至对应斜坡腹侧脑干的中线附近所有硬膜外结构。暴露的斜坡硬膜宽度为19.18±1.44mm，长度为25.44±1.25mm。硬膜内结构如额叶底部、鞍旁区域、大脑纵裂和第三脑室底部也可暴露。
GNKA是一种微创且有效的前颅底入路。以ICL而非鼻根确定切口下缘更方便，且能更好地暴露颅下区域。
