Neurosurgery A Unit, Bordeaux University Hospital, 33076, Bordeaux, France.
Department of Anesthesia and Critical Care, Bordeaux University Hospital, 33076, Bordeaux, France.
Surg Radiol Anat. 2020 Nov;42(11):1371-1375. doi: 10.1007/s00276-020-02525-4. Epub 2020 Jun 30.
The aim of this work was to determine reliable anatomical landmarks for locating and preserving the abducens nerves (6th cranial nerves) during trans-facial or trans-nasal endoscopic approaches of skull base tumors involving the clivus and the petrous apex. In order to describe this specific anatomy, we carefully dissected 10 cadaveric heads under optic magnification. Several measurements were taken between the two petro-sphénoidal foramina, from the bottom of the sella and the dorsum sellae. The close relationship between the nerves and the internal carotid artery were taken into account. We defined a trapezoid area that allowed drilling the clivus safely, preserving the 6th cranial nerve while being attentive to the internal carotid artery. The caudal part of this trapezium is, on average, 20 mm long at mi-distance between the two petro-sphenoidal foramina. The cranial part is at the sella level, a line between both paraclival internal carotid arteries. Oblique lateral edges between the cranial and caudal parts completed the trapezium.
本研究旨在确定可靠的解剖学标志，以便在涉及斜坡和岩尖的颅底肿瘤的经面或经鼻内镜手术中定位和保护外展神经（第 6 颅神经）。为了描述这种特定的解剖结构，我们在光学放大下仔细解剖了 10 个尸体头颅。我们在两个岩蝶孔之间、鞍底和鞍背之间进行了几次测量。还考虑了神经与颈内动脉之间的密切关系。我们定义了一个梯形区域，允许安全地钻颅底，在注意保护颈内动脉的同时保护第 6 颅神经。这个梯形的尾部平均长 20 毫米，位于两个岩蝶孔之间的中距离。头部位于鞍部，在两条岩内颈动脉之间的连线。颅部和尾部之间的斜侧边缘完成了梯形。
