Department of Neurological Surgery, The Ohio State University Medical Center, Columbus, OH, USA.
Department of Pediatric Endocrinology, Nationwide Children's Hospital, Columbus, OH, USA.
Acta Neurochir (Wien). 2021 Feb;163(2):407-413. doi: 10.1007/s00701-020-04590-5. Epub 2020 Sep 19.
Excelsior knowledge of endoscopic anatomy and techniques to remove the natural barriers preventing full endonasal access to the interpeduncular and prepontine cisterns determines the ease of transposing the pituitary gland (hypophysiopexy) preserving the glandular function without manipulating the optic apparatus and the oculomotor nerves.
Throughout stepwise cadaveric dissections, we describe the expanded endonasal approach (EEA) to the interpeduncular and prepontine cisterns with special references to the intricate anatomy of the region and techniques for hypophysiopexy and posterior clinoidectomies.
This article illustrates sellar-diaphragmatic dural incisions and various "pituitary gland transpositions" techniques performed via extradural (lifting the gland still covered by both dural layers), interdural (transcavernous), and intradural (between the medial wall of the cavernous sinus and the pituitary tunica) to access the prepontine and interpeduncular cisterns.
精湛的内镜解剖知识和移除阻碍经鼻内镜充分进入脚间池和脑桥前池的天然屏障的技术，决定了将垂体（垂体固定术）移位的难易程度，同时保持腺体功能，而无需操作视神经和动眼神经。
通过逐步尸体解剖，我们描述了扩大经鼻内镜入路（EEA）至脚间池和脑桥前池，特别提到了该区域复杂的解剖结构以及垂体固定术和后床突切除术的技术。
本文描述了鞍膈硬脑膜切开术和各种“垂体移位”技术，通过硬膜外（提起仍被两层硬脑膜覆盖的腺体）、硬膜间（经蝶窦）和硬脑膜内（海绵窦内侧壁和垂体被膜之间）进入脑桥前池和脚间池。
