Neuroendoscopic anatomy of the pineal region

Abstract

Objective To investigate the charateristics of neuroendoscopic anatomy of the pineal region,discuss the anatomy passage and surgical tips of 2 different procedures,and provide anatomical application fundamentals for neuroendoscope-assisted operation of the pineal region.Methods Fifteen specimens of Chinese adult cadaveric head were selected randomly to simulate neuroendoscope-assisted microneurosurgery via suboccipital transtentorial and infratentorial supracerebellar routes.The exposure range and endoscopic adjustable degrees of anatomical structure of the pineal region through different routes were obsevred,and the related data of the anatomical structure via different routes were measured.Results In the simulating operation through suboccipital transtentorial route,the regulation of neuroendoscopy was flexible and both lateral anatomical structures of the pineal region were exposed clearly; in the simulating operation through inffatentorial supracerebellar route,inferior colliculis were not exposed clearly and the view of this route was stiffness and fixed with difficult regulation of the endoscope.The lengh of Galen's vein (GV) is (10.2±4.1) mm,that of internal cerebral vein (ICV) is (35.0±2.8) mm,that of basal vein (BV) is (35.4±6.4) mm and that of straight sinus is (51.1 ±5.2) mm; the angle GV and straight sinus formed (75.20±10.4)°,including acute angle in 14 cases and obtuse angle in 1.The imaginary extension of straight sinus located inferiorly to the splenium of corpus callosum was observed in 3 cases,located tangently to the splenium of corpus callosum in 11 cases,and located superiorly to the splenium of corpus callosum in 1 case.Conclusion Anatomic structures of the pineal region via neuroendosopic suboccipital transtentorial approach are exposed clearly than those via infratentorial supracerebellar approach,however,dissection oftentorium can improve the regulation ofneuroendoscope and exposition ofcontralateral anatomic structure. Key words: Neuroendoscopy; Pineal region; Operation; Anatomy