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1、StudyoftheAnatomyinvolvingtheendoscopicendonasaltranssphnoidapproachestocavernoussinusABSTRACTObjective:Thecavernoussinusesarevenousstructuresinthemiddlefossa.Itisverydifficulttoexposeduetoitsdeeplocation.Manydiseasesinthisregionareneededtotreatbysurgery.Weuseanatomicalmetho
2、dstoinvestigatethemorphologicalcharacteristicsofadultspecimensandtoprovideanatomicbasisfortheoperationofCS.Methods:Location,surroundingstructures,structuresoflateralwall,superiorwall,medialwallandposteriorwallofCSweredissected,observedandmeasuredon16sidesfrom8cadavericheads.
3、Especially,focusedonthefollowingcontents:Duralstructure,anatomictrianglesandnervesofthewallofCS.LocationandsurroundingstructuresofACP.Location,courseoftheintracavernousinternalcarotidartery.Location,courseandsurroundingstructureofnervethroughCS.Results:①Averagedistancesfromt
4、heanteriornasalspinatotheostiaofsphenoidalsinus,sphenopalatineforamen,andanteriorclinoidprocesswere(58.53士5.11)mm,(50.33士2.42)mm,(80.02士4.96)mm.TheAnglesbetweentheattachmentandsagittalalignmentwereacuteangle,respectively(34.0and2.9)degrees,(20.0and3.5)degreesand(35.2and3.8)d
5、egrees.②Onlyafewspecimenscanfoundopticnerveupliftinsphenoidsinusorinethmoidsinus(4casesand5casesrespectively),mostofthespecimensinsphenoidsinusandethmoidsinusisvisibleintheopticnerveuplift(7cases).Mostofthespecimensinsphenoidsinuscanbeseenintheinternalcarotidarteryuplift(11c
6、ases).③Byendonasaltranssphnoidapproachestocavernoussinus,wecangrindpartboneoftheinsidewallofCStoexposeinternalcarotidartery,thepartinthecavernoussinusandobservecranialnervesinthesinus.④Theexternalwallofthecavernoussinuswastoughandcomposedbyinternalcerebralduramaterandcranial
7、nervesheathmembranelayer,whichwaseasytear.Cranialnerveswereattachedtotheinnermembranelayer(cranialnervesheathmembranelayer).Theinsidewallofcavernoussinuswerethinneratbothendsanddiffer,frontupperpartwaslikefibermembrane,and1casedidnotbesawinspecimen,thelowerwasatough,duralsam
8、ples.⑤Ihecavernoussinuswasfilledwithvenousblood,whichwascomplexforvenousblo