Yu Chengwei, Song Zhenhua, Liu Chengyong, Wei Danian
Department of Neurosurgery, Third Affiliated Hospital of Southern Medical University, Guangzhou 510630, China.
Nan Fang Yi Ke Da Xue Xue Bao. 2020 Nov 30;40(11):1673-1681. doi: 10.12122/j.issn.1673-4254.2020.11.22.
To explore the application of the"five-line division method "in selecting the surgical approach for occupying lesions in the saddle area and its adjacent areas.
Based on the natural anatomic structures, 5 lines (alpha, beta, theta line and lambda, epsilon line) were drawn on the images of the craniocerebral axial plane crossing the middle of the saddle area and the craniocerebral median sagittal plane, thus dividing the saddle area and its adjacent areas into 6 regions in the axial plane (1, 2, 3, 1', 2', and 3' regions) and into 4 regions in the sagittal plane (I, II, III, and IV regions). Based on these divisions, the large space-occupying lesions in the saddle area and adjacent areas were classified and their respective surgical approaches were determined after reviewing the commonly used approaches in the saddle area and clinical experiences. We collected the data of 116 patients undergoing surgeries for space-occupying lesions involving the saddle and the adjacent areas in our hospital between September, 2014 and August, 2017, and analyzed their classifications and the corresponding surgical approaches based on the "five- line division method " to compare the consistency between the hypothetic approaches and the approaches adopted in the actual surgeries.
The actual surgical approaches adopted in the 116 cases were all selected under the guidance of experts in our hospital. The hypothetic surgical approaches selected based on the"five- line division method "showed a good consistency with the actually adopted approaches.
The"five-line division method "can spatially classify the commonly seen space-occupying lesions involving the saddle area and its adjacent area to provide assistance in the selection of surgical approaches for such lesions.
探讨“五线划分法”在鞍区及鞍区周围占位性病变手术入路选择中的应用。
基于自然解剖结构，在穿过鞍区中部的颅脑轴位像及颅脑正中矢状位像上绘制5条线（α线、β线、θ线和λ线、ε线），从而在轴位将鞍区及其周围区域划分为6个区（1区、2区、3区、1'区、2'区和3'区），在矢状位划分为4个区（Ⅰ区、Ⅱ区、Ⅲ区和Ⅳ区）。基于这些分区，对鞍区及鞍区周围的大型占位性病变进行分类，并在回顾鞍区常用手术入路及临床经验后确定各自的手术入路。我们收集了2014年9月至2017年8月间我院116例鞍区及鞍区周围占位性病变手术患者的数据，并基于“五线划分法”分析其分类及相应手术入路，以比较假想入路与实际手术采用入路之间的一致性。
116例患者实际采用的手术入路均在我院专家指导下选择。基于“五线划分法”选择的假想手术入路与实际采用的入路显示出良好的一致性。
“五线划分法”可对鞍区及鞍区周围常见的占位性病变进行空间分类，为这类病变手术入路的选择提供帮助。
