Department of Neurosurgery, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Taizhou 317000, China.
Department of Neurosurgery, Enze Medical Center (Group) Enze Hospital, Taizhou 318050, China.
Int J Clin Pract. 2023 Mar 1;2023:5407912. doi: 10.1155/2023/5407912. eCollection 2023.
Due to a lack of accessibility and individual differences in surgical procedures, many previous studies on keyholes are not practical.
To study the surface landmarks for optimal keyhole placement in the retrosigmoid approach.
The three-dimensional (3D) skull images of 79 patients were reconstructed using workstations, with a total of 149 hemiskull base 3D images then analyzed. Skull-surface landmarks were marked, the lateral-skull surface was observed, and the positional relationships between the asterion and the extension line of the posterior margin of the mastoid process were measured. The position of the superior curvature of the sigmoid sinus groove was located before it was projected onto the lateral surface of the skull and defined as the keypoint. The positional relationship between the keypoint and the skull-surface landmarks was observed in an established coordinate system using spatial proportion relationships.
The asterion was located around the extension line of the posterior margin of the mastoid process, and the vertical distance from the extension line was <15 mm. It was found that 93.29% (139/149) of the keypoints were located in a 7 mm radius circle, with the center at (-0.41, -3.01) in the coordinate system in the 3D computed tomography images.
When using this method, the spatial proportion relationship of the anatomical marks can accurately locate keyholes, therefore providing technical support when employing the retrosigmoid approach.
由于手术过程的可及性和个体差异，许多之前的锁孔研究并不实用。
研究乙状窦后入路中最佳锁孔位置的表面标志。
使用工作站重建了 79 例患者的三维（3D）颅骨图像，共分析了 149 个半颅骨基 3D 图像。标记颅骨表面标志，观察外侧颅骨表面，测量星点与乳突后缘后伸线之间的位置关系。将乙状窦沟上凸的位置投影到颅骨外侧表面之前，将其定义为关键点。在建立的坐标系中，观察关键点与颅骨表面标志之间的位置关系，并利用空间比例关系进行描述。
星点位于乳突后缘后伸线附近，距后伸线的垂直距离<15mm。研究发现，93.29%（139/149）的关键点位于半径为 7mm 的圆内，在三维 CT 图像坐标系中的坐标为（-0.41，-3.01）。
使用该方法时，解剖标志的空间比例关系可以准确地定位锁孔，为乙状窦后入路提供技术支持。
