Department of Neurosurgery, Vita-Salute University, San Raffaele Scientific Institute, Milan, Italy.
World Neurosurg. 2013 Jul-Aug;80(1-2):160-6. doi: 10.1016/j.wneu.2012.06.042. Epub 2012 Aug 13.
We describe a variant of the interhemispheric translaminaterminalis approach for the resection of large suprasellar craniopharyngiomas. The approach is a translaminaterminalis route performed below and above the anterior communicating artery (ACoA). A cadaveric microanatomic study was conducted to describe the surgical technique.
Four cadaveric specimens fixed with gluteraldehyde and injected with latex were dissected to illustrate the approach.
The surgical steps of the approach are reported. The ACoA anatomy was studied. In particular, the surgical route in-between and lateral to the first and second segments of the anterior cerebral artery and the ACoA complex were examined. The approach was adopted in a clinical setting; two illustrative cases regarding the removal of large craniopharyngiomas with suprasellar extension through this route are described.
The approach with preservation of the ACoA may represent a possible route to manage large suprasellar lesions. Combination of the unilateral interhemispheric corridor with the subfrontal and the trans-sylvian routes allows for a safe and radical resection of large suprasellar craniopharyngiomas.
我们描述了一种经胼胝体终板入路切除大型鞍上颅咽管瘤的变异方法。该入路是在前交通动脉（ACoA）下方和上方进行的终板下经颅切开术。进行了一项尸体显微解剖研究来描述手术技术。
对 4 具用戊二醛固定并注入乳胶的尸体标本进行解剖，以说明该入路。
报道了该入路的手术步骤。研究了 ACoA 的解剖结构。特别检查了在前脑动脉的第一和第二段以及 ACoA 复合体之间和外侧的手术路径。该入路已在临床环境中采用；通过该入路切除了两个大型伴有鞍上延伸的颅咽管瘤的病例，说明了该方法的应用。
保留 ACoA 的入路可能是一种处理大型鞍上病变的可行途径。单侧胼胝体通道与额下入路和经侧裂入路的结合可安全彻底地切除大型鞍上颅咽管瘤。
