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术中保留嗅球和嗅束的显微外科解剖学

Microsurgical anatomy for intraoperative preservation of the olfactory bulb and tract.

作者信息

Cömert Ayhan, Uğur Hasan Cağlar, Kahiloğullar Gökmen, Cömert Ela, Elhan Alaittin, Tekdemir Ibrahim

机构信息

Department of Anatomy, Faculty of Medicine, Ankara University, Ankara, Turkey.

出版信息

J Craniofac Surg. 2011 May;22(3):1080-2. doi: 10.1097/SCS.0b013e3182139884.

Abstract

Damage to the olfactory bulb and tract is a frequently described complication of brain surgery in the frontal region, and it seems to be influenced by the surgical approaches. Eighty cerebral hemispheres and 5 formalin-fixed cadavers filled with colored latex were used. Parameters were directly measured, and after olfactory bulb and tract were mobilized with careful dissections, retraction of the frontal lobe was noted. The anterior border of the olfactory bulb is 22.21 (SD, 5.45) mm posterior to the frontomarginal sulcus, and arachnoidal dissection should be performed parallel to olfactory structures using sharp instruments to allow early visualization. Overall mobilization of the olfactory bulb and tract as 29.3 (SD, 6.4) mm in length is possible without disrupting the structures and enables a greater degree of the frontal-lobe elevation window up to 13.1 (SD, 3.2) mm. Using the morphometric data and anatomic knowledge may prevent unwanted anosmia complication during surgical approaches.

摘要

嗅球和嗅束损伤是额叶脑手术中经常被描述的并发症,而且似乎受手术入路的影响。使用了80个大脑半球和5具用彩色乳胶填充的福尔马林固定尸体。直接测量参数,在小心解剖分离使嗅球和嗅束活动后,记录额叶的牵拉情况。嗅球前缘位于额缘沟后方22.21(标准差5.45)mm处,蛛网膜分离应使用锐利器械平行于嗅觉结构进行,以便早期显露。嗅球和嗅束的整体活动长度可达29.3(标准差6.4)mm,而不会破坏结构,并且能使额叶抬高窗口的程度增加至13.1(标准差3.2)mm。利用形态学数据和解剖学知识可预防手术入路过程中出现不必要的嗅觉丧失并发症。

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