临床神经外科杂志2025，Vol.22Issue(2)：188-192,5.DOI:10.3969/j.issn.1672-7770.2025.02.011
内镜经鼻后床突鞍背切除垂体移位暴露脚间池和灰结节入路暴露第三脑室的解剖研究
Endoscopic anatomy of endonasal pituitary transposition trans-tuber-cinereum approach for third ventricle
摘要
Abstract
Objective To explore the anatomical characteristics of the endonasal transsphenoidal pituitary transposition trans-tuber-cinereum approach for third ventricle.Methods Nine adult cranial specimens fixed in formalin were used to simulate the expanded endoscopic endonasal transsphenoidal transtuberculum approach and pituitary transposition.A 0-degree endoscope was employed to observe the interpeduncular cistern.Following the opening of the tuber cinereum,the anatomical landmarks within the third ventricle were explored.The exposure range of the third ventricle was compared with that of the endoscopic transnasal approach via the lamina terminalis.Results This approach involved extradural removal of the bony structures of the sella,including the sella floor,tuberculum sellae,dorsum sellae and posterior clinoid process,followed by a vertical dura incision through the tuberculum sellae to the sella floor.After hemi-transposition of the pituitary gland,the dura of the dorsum sellae was incised to expose the interpeduncular cistern and the arachnoid membrane of the interpeduncular and perimesencephalic cisterns,revealing the floor of the third ventricle(including the mammillary bodies,tuber cinereum,and infundibulum)as well as the neurovascular structures within the interpeduncular cistern.Upon opening the tuber cinereum,access to the third ventricle was achieved,allowing exposure of the anterior part of the third ventricle,including the interventricular foramen,choroid plexus,intermediate mass,bilateral thalami,and the posterior part of the third ventricle,including the posterior commissure,stria medullaris,and choroidal membrane.In comparison to the transnasal approach via the lamina terminalis,exposure of the aqueduct in the lower posterior part of the third ventricle was limited.Conclusions The endonasal pituitary transposition trans-tuber-cinereum approach allows for sufficient exposure of the third ventricle.Compared to the transnasal approach via the lamina terminalis,it results in a smaller defect in the cranial base dura,does not interfere with the optic chiasm,and prioritizes exposure of the floor of the third ventricle,although exposure of the lower posterior part of the third ventricle is limited.关键词
后床突/鞍背/垂体移位/内镜经鼻经终板入路/第三脑室Key words
posterior clinoid process/dorsum sellae/pituitary transposition/endoscopic transnasal approach via the lamina terminalis/third ventricle分类
医药卫生引用本文复制引用
黄锦龙,杨翰涛,谢涛,孙崇璟,张晓彪,李文生,李泽阳,刘腾飞,柳双,陈品..内镜经鼻后床突鞍背切除垂体移位暴露脚间池和灰结节入路暴露第三脑室的解剖研究[J].临床神经外科杂志,2025,22(2):188-192,5.基金项目
上海市科委生物医药项目(22S31902500) （22S31902500）
