Lee Hyun-Woo, Park Hyun-Seok, Yoo Ki-Soo, Kim Ki-Uk, Song Young-Jin
Department of Neurosurgery, College of Medicine, Dong-A University, Busan, Korea.
J Korean Neurosurg Soc. 2013 Jul;54(1):14-8. doi: 10.3340/jkns.2013.54.1.14. Epub 2013 Jul 31.
Although removal of the anterior clinoid process (ACP) is essential surgical technique, studies about quantitative measurements of the space broadening by the anterior clinoidectomy are rare. The purposes of this study are to investigate the dimension of the ACP, to quantify the improved exposure of the parasellar space after extradural anterior clinoidectomy and to measure the correlation of each structure around the paraclinoidal area.
Eleven formalin-fixed Korean adult cadaveric heads were used and frontotemporal craniotomies were done bilaterally. The length of C6 segment of the internal carotid artery on its lateral and medial side and optic nerve length were checked before and after anterior clinoidectomy. The basal width and height of the ACP were measured. The relationships among the paraclinoidal structures were assessed. The origin and projection of the ophthalmic artery (OA) were investigated.
The mean values of intradural basal width and height of the ACP were 10.82 mm and 7.61 mm respectively. The mean length of the C6 lateral and medial side increased 49%. The mean length of optic nerve increased 97%. At the parasellar area, the lengths from the optic strut to the falciform liament, distal dural ring, origin of OA were 6.69 mm, 9.36 mm and 5.99 mm, respectively. The distance between CN III and IV was 11.06 mm.
With the removal of ACP, exposure of the C6 segments and optic nerve can expand 49% and 97%, respectively. This technique should be among a surgeon's essential skills for treating lesions around the parasellar area.
尽管切除前床突（ACP）是一项重要的外科技术，但关于前床突切除术所致空间扩大的定量测量研究却很少见。本研究的目的是调查前床突的尺寸，量化硬膜外前床突切除术后鞍旁间隙暴露的改善情况，并测量鞍旁区域周围各结构的相关性。
使用11个经福尔马林固定的韩国成年尸体头颅，双侧进行额颞开颅术。在进行前床突切除术前后，检查颈内动脉C6段外侧和内侧的长度以及视神经长度。测量前床突的基底宽度和高度。评估鞍旁结构之间的关系。研究眼动脉（OA）的起源和走行。
前床突硬膜内基底宽度和高度的平均值分别为10.82mm和7.61mm。C6段外侧和内侧的平均长度增加了49%。视神经的平均长度增加了97%。在鞍旁区域，从视柱到镰状韧带、远侧硬膜环、眼动脉起源的长度分别为6.69mm、9.36mm和5.99mm。动眼神经和滑车神经之间的距离为11.06mm。
切除前床突后，C6段和视神经的暴露可分别扩大49%和97%。这项技术应是外科医生治疗鞍旁区域病变的必备技能之一。
