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鞍隔孔及毗邻结构的解剖变异:尸体研究。

Anatomical variations of foramen of the diaphragma sellae and neighboring structures: a cadaveric study.

机构信息

School of Medicine, Bahcesehir University, Istanbul, Turkey.

Department of Anatomy, School of Medicine, Bahcesehir University, Istanbul, Turkey.

出版信息

Anat Sci Int. 2024 Jan;99(1):75-89. doi: 10.1007/s12565-023-00736-4. Epub 2023 Jul 27.

Abstract

The aim of our study was to examine the variations and types of foramen of diaphragma sellae (FDS) and their relationship with nearby surgical landmarks on cadavers.Twenty adult (9 male, 11 female) formalin-fixed cadaveric heads were bilaterally used to analyze the anatomical relationships around the supradiaphragmatic region of sella turcica. Lengths and distances of nearby surgical landmarks were measured by a digital microcaliper. SPSS version 25 was used to analyze the comparison between genders and body sides. Dorsum sellae distances to tuberculum sellae and the optic chiasm(OC) were higher in males than females (p < 0.05). Type 8 infundibulum passage was the most common variation with 50%. There was no finding related to types 1-4 of infundibulum passage. Thus, the present study has indicated that the infundibulum passes mostly from the posterior half of the foramen. The shape of the foramen was irregular in 45%, circular in 20%, sagittally oval in 20%, and horizontally oval in 15% of the cases. The OC was noted normal in 60%, prefixed in 35%, and postfixed in 5% of the cases. Comprehensive anatomical knowledge about the types of the FDS and their neighboring structures is crucial for preoperative planning of sellar region diseases in terms of navigating the region when accessing the foramen. Discrimination of variations of FDS, OC, and pituitary stalk, their relationships, and differences between genders is useful to minimize potential surgical complications.

摘要

我们研究的目的是检查鞍膈裂孔(FDS)的变化和类型及其与尸体附近手术标志的关系。使用 20 个成人(9 男,11 女)福尔马林固定的头颅标本,双侧分析鞍结节区上方的解剖关系。使用数字测微卡尺测量附近手术标志的长度和距离。使用 SPSS 版本 25 分析性别和身体侧之间的比较。男性的鞍结节和视交叉(OC)距鞍结节距离高于女性(p < 0.05)。漏斗管通过 8 型是最常见的变异,占 50%。没有发现与漏斗管通过 1-4 型相关的变异。因此,本研究表明漏斗管大多从孔的后一半通过。孔的形状不规则占 45%,圆形占 20%,矢状椭圆形占 20%,水平椭圆形占 15%。OC 在 60%的病例中正常,35%的病例中前置,5%的病例中后置。关于 FDS 及其邻近结构的类型的全面解剖学知识对于鞍区疾病的术前规划至关重要,因为在进入孔时需要在该区域导航。区分 FDS、OC 和垂体柄的变异、它们之间的关系以及性别之间的差异有助于最大限度地减少潜在的手术并发症。

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