Applied endoscopic anatomy study of operative fissures in sellar region via pterional keyhole approach

Abstract

Objective To study the neuroendoscopic anatomy of operative fissures in sellar region via pterional keyhole approach, providing an anatomical basis for neuroendoscope-assisted microneurosurgery (EAM) via this approach. Methods A total of 15 cadaveric heads were dissected via pterional keyhole approach and the anatomical structure of the five operative fissures were studied with neuroendoscope. Results Microanatomy of the operative fissures in sellar region was observed well by neuroendoscope, especially the minute structures, such as the superior hypophyseal artery (SHA)and the perforating arteries, backside hidden but important structures of which were inspected with angle endoscope bypassing the nerves or arteries. Conclusion An endoscope can be applied to enlarge the visible field of microsurgical anatomy in sellar region via peterional keyhole approach microsurgery.The neuroendoscope-assisted microsurgery can reduce intraoperative distraction of brain tissues and focal vessels or nerves in skull bottom, and complications to improve the efficacy of microsurgery in sellar region. Key words: Pterional approach; Keyhole approach; Sellar region; Neuroendoscopic anatomy