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首页> 外文期刊>British journal of neurosurgery >Anatomical landmarks for positioning the head in preparation for the transsphenoidal approach: the spheno-sellar point.
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Anatomical landmarks for positioning the head in preparation for the transsphenoidal approach: the spheno-sellar point.

机译：用于准备经蝶骨入路的头部解剖学界标：蝶点。

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The transnasal approach is the most utilized approach to the sellar region. This study was conducted to identify an anatomical landmark on the lateral surface of the head that corresponds to the midpoint of the sellar floor at the level of sphenoidal rostrum. This point, lined up with the nostril, simulates the surgical path and facilitates the transnasal access to the sella turcica. Four adult, formalin-fixed and silicon-injected cadaveric heads, and ten dried skulls were used for laboratory dissection. The heads and skulls were sectioned along the midline; and the spheno-sellar point, corresponding to the midpoint of the sellar floor at the level of sphenoid rostrum, was determined. The spheno-sellar point was plotted on the lateral surface of the skull, and its position measured relative to the external acoustic meatus. Linking the spheno-sellar point with the nostril created the spheno-nostril line. This line represents the surgical path to be taken for direct access to the sphenoid rostrum, and was used to align the cadaveric heads as in surgery. The endonasal transsphenoidal approach was then utilized in one hundred and two adult patients with sellar lesions, using the spheno-sellar point and the spheno-nostril line as the superficial landmarks to guide the approach. The results of this clinical experience are summarized. The spheno-sellar point was found to be located an average of 40.1 mm (SD+/-2.9 mm) anterior and 23.3 mm (SD+/-3.2 mm) superior to the external acoustic meatus. The spheno-nostril line represents the straight surgical path to the sphenoidal rostrum. This landmark was used in 102 correlative transnasal surgeries for sellar lesions of adult patients, and has allowed an easy and straightforward access to the sella. In only 3 cases with poor pneumatisation of the sphenoid sinus (presellar type), the actual location of the surgical instruments had to be confirmed by fluoroscopy. The application of the spheno-sellar point and the spheno-nostril line is a fast, reliable and very simple way to facilitate transsphenoidal surgery, and their use may avoid complications associated with misdirection of this approach. Its use may be limited in cases of poor pneumatisation of the sphenoid sinus, where fluoroscopic guidance could be necessary as a rule.
机译：经鼻入路是对鞍区最常用的入路。进行这项研究是为了确定头部侧面的解剖标志，该标志对应于蝶骨骨盆水平的鞍底的中点。与鼻孔对齐的这一点模拟了手术路径，并促进了鼻腔通入蝶鞍。使用四个成年的，福尔马林固定的和硅注射的尸体头以及十个干燥的头骨进行实验室解剖。头颅和颅骨沿中线切开。并确定蝶鞍-蝶鞍点，对应蝶鞍水平处蝶鞍底的中点。蝶突点绘制在颅骨的侧面，并相对于外耳道测量其位置。将蝶鼻点与鼻孔链接会创建蝶鼻线。该线表示直接进入蝶骨讲台所要采用的手术路径，并且像在手术中一样用于对齐尸体头部。然后，鼻翼经蝶窦入路用于102名成年患者的蝶鞍状病变，以蝶鞍点和蝶鼻孔线为表面标志物来指导该方法。总结了该临床经验的结果。发现蝶鞍点比前耳道平均高40.1毫米（SD +/- 2.9毫米），比外耳道高23.3毫米（SD +/- 3.2毫米）。蝶鼻孔线代表通向蝶骨讲台的直线手术路径。这个标志性建筑被用于成年患者的蝶鞍病变的102例相关的经鼻手术中，并且可以轻松，直接地进入蝶鞍。仅3例蝶窦气化不良（前鞍型），必须通过透视检查确定手术器械的实际位置。蝶鞍点和蝶鼻孔线的应用是促进经蝶窦手术的快速，可靠和非常简单的方法，它们的使用可以避免与这种方法的误导相关的并发症。在蝶窦气化不良的情况下，其使用可能会受到限制，通常需要进行透视检查。

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