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经鼻内镜蝶鞍区手术的立体解剖研究方法

Three-dimensional anatomical research on sellar region for transasal endoscopic surgery

摘要目的 探讨一种立体解剖学方法,研究经鼻内镜蝶鞍区手术中重要解剖结构的空间关系,为经鼻内镜蝶鞍区手术提供立体解剖学参考.方法 ①改进MicronTracker双日视觉导航仪,并检验其测量角度与距离的准确性.②依次暴露10具(20侧)去脑颅底湿标本蝶鞍区重要结构,以S点(同侧鼻棘侧缘点)和M点(上颌线中点)为基准点,鼻底平面和正中矢状面为基准平面,应用MicronTracker双目视觉导航仪测量基准点到各解剖标志连线的俯仰角、方向角和距离,并行统计学处理.③利用3D-max和AutoCAD-2008软件建立蝶鞍区解剖结构的立体模型.结果 ①改进的MicronTracker双目视觉导航仪与游标卡尺及角度转台之间的测量值差异无统计意义(P值均>0.05).②测量得到了蝶窦口、视神经-颈内动脉隐窝、球形鞍底、蝶窦后壁、斜坡中部顶点及外侧顶点等重要结构或标志的定位数据.③应用3D-max 9.0和AutoCAD-2008软件建立蝶鞍区解剖结构的立体模型.结论 应用改进MicronTracker双目视觉导航仪可得到蝶鞍区重要解剖结构定位数据,并在此基础上建立经鼻内镜蝶鞍区手术解剖结构的立体构象.

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abstractsObjective To develope a new method to explore the three-dimensional characteristics of anatomical structures at the sellar region in transnasal endoscopic surgery. Methods ① The MicronTracker binocular visual navigation system was modified, and the tool's accuracy was tested by comparing the vernier caliper and turntable. ②The basis nasi plane and median sagittal plane were used as datum plane, S point (the lateral margin point of nasal spine ) and M point (maxillary line midpoint) were used as datum point to orientate the structures. The pitching angle, direction angle and distance of the important structures were measured by the tool designed by us based on the MicronTracker binocular visual navigation system and made a computer graphics model Results ①The tool's accuracy bad no statistical difference as compared with vernier caliper and turntable. ② The pitching angle, direction angle and distance of the important structures were obtained.③ 3D-max 9. 0 and AutoCAD-2008 were used to set up three-dimensional anatomical model of the anatomical structures. Conclusion Based on the familiar point and datum of the skull, the orientation data of the important structures could be obtained and the three-dimensional model of the sella region anatomical structures could be constructed.

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