Microsurgical anti endoscopic anatomy of sellar region related to key hole approach

Abstract

Objective To study the endoscopic anatomy of operative fissures in the sellar region related to pterional key-hole approach and to provide the anatomic basis for endoscope-assisted microneuro-surgery in the region. Methods Fifteen cadaver heads were dissected via pterional key-hole approach and the five operative fissures(Ⅰ、Ⅱ、Ⅲ、Ⅳ、Ⅴ) were studied with both microscope and endoscope, by which the outcomes observed were recorded and compared. Results The basic information obtained by the pterio-nalkeyhole approach was comparable to that of the classic ptefional approach. According to the anatomic guideposts under neuroendoscope, the microstructures of the five fissures and Willis' circle would be well demonstrated. It is better to display the various anatomic structures in sellar region by neuroendoscope rather than microscope, particularly some important microstructures. Angled endoscope can be used to inspec thidden but important structure behind the arteries and nerves. Conclusion According to the anatomic guideposts, an endoscopy can be used to enhance the visible field of an operative microscope related to pterional key-hole approach. The endoscope-assisted microsurgery can reduce complications and injury of the important structures and increase the curative effect on the lesions in the sellar region. Key words: Pterional approach; Sellar region; Key hole approach; Neuro-endoscopy; Microanatomy