Knappe Ulrich J, Konerding Moritz A, Schoenmayr Robert
Department of Neurosurgery, Johannes Wesling Klinikum, Hans-Nolte-Str. 1, 32429 Minden, Germany.
Acta Neurochir (Wien). 2009 Aug;151(8):961-7; discussion 967. doi: 10.1007/s00701-009-0340-3. Epub 2009 Apr 30.
To elucidate the question whether expansion of pituitary adenomas into the cavernous sinus (CS) has to be regarded as focal penetration rather than invasion, a microanatomical study of the medial wall (MW) of the CS was performed.
Fourteen sellar hemiblocks underwent microsurgical dissection from lateral and medial approach. The thickness of the MW of the CS was examined by diaphanoscopy.
The internal carotid artery (ICA) was adherent to the MW in five cases. In five specimens the lateral wall of the sella turcica consisted of a single layer without perforations. In nine cases this wall had two layers. There was no perforation of both layers in any case. Diaphanoscopy revealed thin MW in the lateral border of the sella (n = 13), below the horizontal segment of the ICA (n = 10), and antero-inferiorly to the carotid syphon (n = 9).
Expansion into the CS may be facilitated by low anatomical resistance against chronic tumor growth.
为阐明垂体腺瘤向海绵窦（CS）扩展应被视为局灶性穿透而非浸润这一问题，对CS内侧壁（MW）进行了微观解剖学研究。
对14个蝶鞍半块标本分别从外侧和内侧入路进行显微手术解剖。通过透照法检查CS内侧壁的厚度。
5例中颈内动脉（ICA）与内侧壁粘连。5个标本中蝶鞍外侧壁为单层且无穿孔。9例中该壁有两层。在任何情况下两层均无穿孔。透照法显示蝶鞍外侧缘（n = 13）、ICA水平段下方（n = 10）以及颈动脉虹吸部前下方（n = 9）的内侧壁较薄。
对慢性肿瘤生长的解剖学阻力较低可能有助于向海绵窦扩展。
