Chowdhury Forhad H, Haque Mohammod R, Kawsar Khandkar A, Ara Shamim, Mohammod Quazi Deen, Sarker Mainul H, Goel Atul H
Dhaka Medical College Hospital, Department of Neurosurgery, Dhaka, Bangladesh.
Turk Neurosurg. 2012;22(1):68-76. doi: 10.5137/1019-5149.JTN.4887-11.2.
Endonasal transsphenoidal approaches are getting rapidly popular in removing many midline skullbase lesions from crista galli to foramen magnum. For safe removal of these lesions, familiarity with endoscopic endonasal anatomy of circle of Willis is very important. Furthermore, for safe development of this approach in vascular neurosurgery in the near future, endoscopic endonasal exposure of circle of Willis is a fundamental step. The goals in this study were to dissect the circle of Willis completely through the endoscopic endonasal approach and to become more familiar with the views and skills associated with the technique by using fresh cadaveric specimens.
After obtaining ethical clearance, 26 fresh cadaver heads were used without any preparation. Using a neuroendoscope, complete exposure of the circle of Willis was done endonasaly, and various observations including relation of circle of Willis was recorded.
Complete exposure of the circle of Willis was made through an endonasal approach in all cases without injuring surrounding structures.
Endoscopic endonasal extended transsphenoidal exposure of CW can make the surgeon more efficient in removing midline skullbase lesions with safe handling of different parts of circle of Willis and it may help in development of endonasal endoscopic vascular neurosurgery in the near future.
经鼻蝶窦入路在切除从鸡冠到枕大孔的许多中线颅底病变方面正迅速流行。为了安全切除这些病变，熟悉 Willis 环的鼻内镜鼻内解剖结构非常重要。此外，为了在不久的将来安全开展血管神经外科的这种手术入路，Willis 环的鼻内镜鼻内暴露是一个基本步骤。本研究的目的是通过鼻内镜鼻内入路完全解剖 Willis 环，并通过使用新鲜尸体标本更熟悉与该技术相关的视野和技巧。
获得伦理批准后，使用26个未经任何处理的新鲜尸体头部。使用神经内镜经鼻内完成 Willis 环的完全暴露，并记录包括 Willis 环关系在内的各种观察结果。
所有病例均通过鼻内入路完成 Willis 环的完全暴露，且未损伤周围结构。
鼻内镜鼻内扩大经蝶窦暴露 Willis 环可使外科医生在安全处理 Willis 环不同部位的情况下，更高效地切除中线颅底病变，并且可能有助于在不久的将来发展鼻内镜血管神经外科。
