Ebner Florian H, Koerbel Andrei, Roser Florian, Hirt Bernhard, Tatagiba Marcos
Department of Neurosurgery, Eberhard-Karls-University, Tuebingen, Germany.
Skull Base. 2009 Sep;19(5):319-23. doi: 10.1055/s-0029-1220199.
This article evaluates the accessibility of the posterior part of the central skull base via the extended retrosigmoid intradural suprameatal approach. In formaldehyde-fixed specimens, the retrosigmoid intradural suprameatal approach was performed, and the feasibility of reaching central skull base structures was analyzed. Microscopic and endoscopic techniques were used. The main outcome measures were digital films and screenshots, which were analyzed regarding quantitative and qualitative aspects of visual structures. By drilling off the suprameatal tubercle and part of the petrous apex, Meckel's cave may be opened, the trigeminal nerve mobilized, and the tentorium divided. Thus the parasellar area may be exposed and the posterosuperior space of the cavernous sinus approached. Using an endoscope-assisted technique and following cisternal anatomy, the sellar and parasellar region may be explored even if the working space is narrow. The retrosigmoid intradural suprameatal approach provides optimal accessibility to medially located central skull base structures, in particular to the posterior part of the cavernous sinus. Use of the endoscope may remarkably optimize the accessibility.
本文通过扩大乙状窦后硬膜内入路评估中颅底后部的可达性。在甲醛固定标本上，采用乙状窦后硬膜内入路，分析到达中颅底结构的可行性。使用了显微镜和内镜技术。主要观察指标为数字影片和截图，对视觉结构的定量和定性方面进行分析。通过磨除颞骨岩部上结节和部分岩尖，可打开Meckel腔，游离三叉神经，切开小脑幕。从而可暴露鞍旁区域并接近海绵窦后上间隙。采用内镜辅助技术并遵循脑池解剖结构，即使工作空间狭窄，也可探查鞍区和鞍旁区域。乙状窦后硬膜内入路为位于内侧的中颅底结构，特别是海绵窦后部提供了最佳可达性。使用内镜可显著优化可达性。
