Tang Ke, Feng Xu, Li Yang
Institute of Neurosurgery, The First Medical Center of Chinese PLA General Hospital, Fuxing Road 28, Beijing, 100853, People's Republic of China.
Department of Basic Medicine, Xiamen Medical College, Guan kou zhong Road 1999, Xiamen, Fujian Province, 361023, People's Republic of China.
Chin Neurosurg J. 2022 Jan 10;8(1):1. doi: 10.1186/s41016-021-00268-8.
The three-dimensional (3D) visualization model has ability to quantify the surgical anatomy of far-lateral approach. This study was designed to disclose the relationship between surgical space and exposed tissues in the far-lateral approach by the volumetric analysis of 3D model.
The 3D skull base models were constructed using MRI and CT data of 15 patients (30 sides) with trigeminal neuralgia. Surgical corridors of the far-lateral approach were simulated by triangular pyramids to represent two surgical spaces exposing bony and neurovascular tissues. Volumetric comparison of surgical anatomy was performed using pair t test.
The morphometric results were almost the same in the two surgical spaces except the vagus nerve (CN X) exposed only in one corridor, whereas the volumetric comparison represented the statistical significant differences of surgical space and bony and neurovascular tissues involved in the two corridors (P<0.001). The differences of bony and neurovascular tissues failed to equal the difference of surgical space.
For far-lateral approach, the increase of exposure for the bony and neurovascular tissues is not necessarily matched with the increase of surgical space. The volumetric comparative analysis is helpful to provide more detailed anatomical information in the surgical design.
三维（3D）可视化模型能够对远外侧入路的手术解剖结构进行量化。本研究旨在通过3D模型的容积分析揭示远外侧入路中手术空间与暴露组织之间的关系。
利用15例三叉神经痛患者（30侧）的MRI和CT数据构建3D颅底模型。远外侧入路的手术通道用三棱锥模拟，以代表暴露骨组织和神经血管组织的两个手术空间。采用配对t检验对手术解剖结构进行容积比较。
除迷走神经（CN X）仅在一个通道中暴露外，两个手术空间的形态学结果几乎相同，而容积比较显示两个通道中手术空间以及所涉及的骨组织和神经血管组织存在统计学显著差异（P<0.001）。骨组织和神经血管组织的差异与手术空间的差异不相等。
对于远外侧入路，骨组织和神经血管组织暴露的增加不一定与手术空间的增加相匹配。容积对比分析有助于在手术设计中提供更详细的解剖学信息。
