内镜下经鼻蝶到海绵窦区手术入路的解剖学研究
|
摘要
目的:探讨海绵窦区内镜下的显微解剖,为经鼻蝶入路内镜辅助下海绵窦内肿瘤手术切除提供解剖学依据。
材料和方法:在8具(16侧)成人尸头标本上,利用0度、30度角,直径为4mm的神经内镜进行研究,全部经鼻中甲入路,切除蝶窦前壁到达蝶窦后壁,磨除蝶窦后壁的骨质层,进入海绵窦区进行研究测量拍照。
结果:1.海绵窦呈粗细不等,反复分支,反复汇合的网状结构,这些网状结构与颈内动脉相互毗邻,并可于手术显微镜下完整分离,使外科医生切除海绵窦肿瘤成为可能。2.海绵窦内侧壁的胶原纤维层明显较海绵窦上壁和外侧壁为薄,海绵窦内侧壁实际上是由鞍膈发出的纤维构成的薄壁。左右海绵窦的内侧壁即为垂体硬膜囊的两侧外侧壁,作为垂体和海绵窦的边界并将两者分隔开来。3.内镜下蝶窦后壁的骨质层分为五个相互垂直的区域:中央区、双侧对称的旁中央区及外侧区。中央区的主要结构有:蝶骨平台、鞍结节、蝶鞍和斜坡凹陷;旁中央区的主要结构有:视神经管的内三分之一和颈内动脉隆突;外侧区主要包含四个骨性隆突(视神经管隆突、海绵窦尖隆突、上颌窦隆突和下颌窦隆突)和三个隐窝(视神经-颈内动脉隐窝、眼神经-上颌神经隐窝〈V1-V2〉、上颌神经-下颌神经隐窝〈V2-V3〉)。这三个隐窝在外侧区形成了三个解剖三角:视柱三角(由视神经、颈内动脉、动眼神经围成)、V1-V2三角、V2-V3三角。4.内镜下蝶窦后壁,通过其各自的骨性隆突可以明显的看到海绵窦内颈内动脉的两个分段,即尾侧的斜坡旁段和头侧的鞍旁段,斜坡旁段的颈内动脉可被进一步分为两个部分:位于海绵窦外的尾侧的破裂孔段和位于海绵窦内的三叉神经段。当蝶窦内的粘膜被去除后,可以看到颈内动脉的破裂孔段。鞍旁颈内动脉呈一个凸向前外侧的“C”形。它可被进一步分为四个部分,从尾侧到头侧分别为:潜隐段、下水平段、前垂直段、上水平段。
结论:1海绵窦是由粗细不等的静脉所组成的一个不规则的静脉丛,反复分支吻合,不完全包绕颈内动脉。2海绵窦的内侧壁由覆盖于垂体的内层硬膜构成。3.内镜下通过蝶窦后壁的骨质层五分区可顺利进入海绵窦区,海绵窦内颈内动脉的分段,使临床切除海绵窦内肿瘤时避免损伤重要血管神经成为可能。
Objective : The endoscopic surgical anatomy of the medial wall of the cavernous sinus was studied to establish an anatomic basis for tumors treatment involving in the medial wall of the cavernous sinus.
Materials and methods: Eight adult (16 sides) cadaveric heads were studied under endoscope 0 and 70 degree 4-mm rod-lens. The posterior wall of the sphenoidal sinus was operated via a middle meatal approach. The exposure of the posterior wall of the sphenoidal sinus was followed by an anterior sphenoidaotomy. To measure and photograph the structures after cut the bony floor.
Results: 1. The cavernous sinus is network structure of thickness ranging, repeatedly branches and convergences, not cysts. These mesh structure and ICA adjacent to each other, and under in a complete separation the operating microscope, so that it is possible for removing the rumors invading cavernous sinus surgeon removed the tumor cavernous possible.2. The medial wall of the cavernous sinus is actually issued by the diaphragma sellae fibers consisting of thin-walled.The collagen fibers in the medial wall of the cavernous sinus is significantly less than those in the superior and lateral wall of the cavernous sinus. It is actually originated from the diaphragma sellae fibers thin-walled structure and to be the border of the pituitary gland and cavernous sinus.3. The posterior bony wall of the sphenoidal sinus is subdivided into five vertical compartments: midline, bilateral paramedian, and bilateral lateral. The midline vertical compartment consists of the planum sphenoidale, tuberculum sellae, sella, and clival indentation. The paramedian vertical compartment is composed of the medial third of the optic canal and the carotid artery protuberance. The lateral vertical compartment contains four bony protuberances (optic, cavernous sinus apex, maxillary, and mandibular) and three depressions (carotico-optic, ophthalmomaxillary [V1-V2], and maxillomandibular [V2-V3]). The three depressions form anatomic triangles at the lateral vertical compartment: the optic strut triangle, which is bordered by the optic nerve, carotid artery, and oculomotor nerve (IIIrd cranial nerve); the V1-V2 triangle; and the V2-V3 triangle. The paraclival ICA segment can be further subdivided into two parts: the lacerum segment caudally (the extracavernous sinus) and the trigeminal segment rostrally (the intracavemous sinus). When the mucosa of the sphenoidal sinus is removed, the lacerum segment of the ICA can be identified as a bare artery if fibrocartilage is absent.4. The parasellar segment of the ICA is C-shaped, with the convexity of the "C" facing anterolaterally when it is viewed from the medial aspect. It is subdivided into four parts in a caudal-to-rostral order: the "hidden segment," the inferior horizontal segment, the anterior vertical segment, and the superior horizontal segment.
Conclusions: 1. The cavernous sinus is an irregular venous plexus which is composed with thickness ranging from vein, a branch line repeatedly, not entirely enveloping the ICA. 2 The medial wall of the cavernous sinus is formed by the dura propria that covers the pituitary gland. Trans the posterior wall of the sphenoid sinus under the endoscopy can access to the medial wall of the cavernous sinus and the ICA. It is possible for doctors to remove tumors involving the lateral wall of cavernous sinus without neurovascular injury.
材料和方法:在8具(16侧)成人尸头标本上,利用0度、30度角,直径为4mm的神经内镜进行研究,全部经鼻中甲入路,切除蝶窦前壁到达蝶窦后壁,磨除蝶窦后壁的骨质层,进入海绵窦区进行研究测量拍照。
结果:1.海绵窦呈粗细不等,反复分支,反复汇合的网状结构,这些网状结构与颈内动脉相互毗邻,并可于手术显微镜下完整分离,使外科医生切除海绵窦肿瘤成为可能。2.海绵窦内侧壁的胶原纤维层明显较海绵窦上壁和外侧壁为薄,海绵窦内侧壁实际上是由鞍膈发出的纤维构成的薄壁。左右海绵窦的内侧壁即为垂体硬膜囊的两侧外侧壁,作为垂体和海绵窦的边界并将两者分隔开来。3.内镜下蝶窦后壁的骨质层分为五个相互垂直的区域:中央区、双侧对称的旁中央区及外侧区。中央区的主要结构有:蝶骨平台、鞍结节、蝶鞍和斜坡凹陷;旁中央区的主要结构有:视神经管的内三分之一和颈内动脉隆突;外侧区主要包含四个骨性隆突(视神经管隆突、海绵窦尖隆突、上颌窦隆突和下颌窦隆突)和三个隐窝(视神经-颈内动脉隐窝、眼神经-上颌神经隐窝〈V1-V2〉、上颌神经-下颌神经隐窝〈V2-V3〉)。这三个隐窝在外侧区形成了三个解剖三角:视柱三角(由视神经、颈内动脉、动眼神经围成)、V1-V2三角、V2-V3三角。4.内镜下蝶窦后壁,通过其各自的骨性隆突可以明显的看到海绵窦内颈内动脉的两个分段,即尾侧的斜坡旁段和头侧的鞍旁段,斜坡旁段的颈内动脉可被进一步分为两个部分:位于海绵窦外的尾侧的破裂孔段和位于海绵窦内的三叉神经段。当蝶窦内的粘膜被去除后,可以看到颈内动脉的破裂孔段。鞍旁颈内动脉呈一个凸向前外侧的“C”形。它可被进一步分为四个部分,从尾侧到头侧分别为:潜隐段、下水平段、前垂直段、上水平段。
结论:1海绵窦是由粗细不等的静脉所组成的一个不规则的静脉丛,反复分支吻合,不完全包绕颈内动脉。2海绵窦的内侧壁由覆盖于垂体的内层硬膜构成。3.内镜下通过蝶窦后壁的骨质层五分区可顺利进入海绵窦区,海绵窦内颈内动脉的分段,使临床切除海绵窦内肿瘤时避免损伤重要血管神经成为可能。
Objective : The endoscopic surgical anatomy of the medial wall of the cavernous sinus was studied to establish an anatomic basis for tumors treatment involving in the medial wall of the cavernous sinus.
Materials and methods: Eight adult (16 sides) cadaveric heads were studied under endoscope 0 and 70 degree 4-mm rod-lens. The posterior wall of the sphenoidal sinus was operated via a middle meatal approach. The exposure of the posterior wall of the sphenoidal sinus was followed by an anterior sphenoidaotomy. To measure and photograph the structures after cut the bony floor.
Results: 1. The cavernous sinus is network structure of thickness ranging, repeatedly branches and convergences, not cysts. These mesh structure and ICA adjacent to each other, and under in a complete separation the operating microscope, so that it is possible for removing the rumors invading cavernous sinus surgeon removed the tumor cavernous possible.2. The medial wall of the cavernous sinus is actually issued by the diaphragma sellae fibers consisting of thin-walled.The collagen fibers in the medial wall of the cavernous sinus is significantly less than those in the superior and lateral wall of the cavernous sinus. It is actually originated from the diaphragma sellae fibers thin-walled structure and to be the border of the pituitary gland and cavernous sinus.3. The posterior bony wall of the sphenoidal sinus is subdivided into five vertical compartments: midline, bilateral paramedian, and bilateral lateral. The midline vertical compartment consists of the planum sphenoidale, tuberculum sellae, sella, and clival indentation. The paramedian vertical compartment is composed of the medial third of the optic canal and the carotid artery protuberance. The lateral vertical compartment contains four bony protuberances (optic, cavernous sinus apex, maxillary, and mandibular) and three depressions (carotico-optic, ophthalmomaxillary [V1-V2], and maxillomandibular [V2-V3]). The three depressions form anatomic triangles at the lateral vertical compartment: the optic strut triangle, which is bordered by the optic nerve, carotid artery, and oculomotor nerve (IIIrd cranial nerve); the V1-V2 triangle; and the V2-V3 triangle. The paraclival ICA segment can be further subdivided into two parts: the lacerum segment caudally (the extracavernous sinus) and the trigeminal segment rostrally (the intracavemous sinus). When the mucosa of the sphenoidal sinus is removed, the lacerum segment of the ICA can be identified as a bare artery if fibrocartilage is absent.4. The parasellar segment of the ICA is C-shaped, with the convexity of the "C" facing anterolaterally when it is viewed from the medial aspect. It is subdivided into four parts in a caudal-to-rostral order: the "hidden segment," the inferior horizontal segment, the anterior vertical segment, and the superior horizontal segment.
Conclusions: 1. The cavernous sinus is an irregular venous plexus which is composed with thickness ranging from vein, a branch line repeatedly, not entirely enveloping the ICA. 2 The medial wall of the cavernous sinus is formed by the dura propria that covers the pituitary gland. Trans the posterior wall of the sphenoid sinus under the endoscopy can access to the medial wall of the cavernous sinus and the ICA. It is possible for doctors to remove tumors involving the lateral wall of cavernous sinus without neurovascular injury.
引文
1.王任直,康军,苏长保,等.CS内侧壁的显微解剖与扩大经蝶窦入路治疗侵袭CS的垂体腺瘤,中国微侵袭神经外科杂志,2008,13:100-103
2.Tuccar E,Uz A,Tekdemir I,et al.Anatomical study of the lateral wall of the cavernous sinus,emphasizing dural construction and neural relation[J].Neurosurg Rev,2000,23(1):45-48.
3.江涛,王忠诚,于春江,等。CS显微外科相关三角解剖学研究[J].中华神经外科杂志,1999,15(1):45-49.
4.Inoue T,Rhoton AL Jr,Theele D,et al.Surgical approaches to the cavernous sinus:A microsurgical study[J].Neurosurgery,1990,26(6):903-932.
5.Bedford MA.The cavernous sinus[J].Br J Ophthal,1966,50:41-4
6.Taptas JN.The so-called cavernous sinus:a review of the comtroversyand its implications for neurosurgeons[J].Neurosurg,1982,11(5):712-717.
7.Cappabianca P,Cavallo LM,Mariniello G,de Divitiis O,Becerra Romero ADC,de Divitiis E:Easy sellar reconstruction in endoscopic endonasal transsphenoidal surgery with polyester-silicone dural substitute and fibringlue:Technical note.Neurosurgery 49:473-476,2001.
8.Parksin D.A surgical approach to the cavernous portion of thecarotid artery:anatomical studies and case report[J].J Neurosurg,1965,23(5):474-483.
9.Parkinson D.Lateral sellar compartment:history and anatomy[J].J Craniofae Surg,1995,6(1):55-68.
10.Lang J,Kageyama I.Clinical anatomy of the blood spaces andblood vessels surrounding the siphon of the internal carotid artery[J].Acta Anat,1990,139:320-325.
11.Weninger WJ,Streicher J,Muller CB.Anatomical compartmentof the parasellar region:adipose tissue bodies represent intracranial continuations of extracranial spases[J].J Anat,1997,191(pt2):269-275.
12.Liu ZHX,Liu YSH.Microanatomy of cavernous sinus and its clinicalimport-ance [J].Foreign medical Sciences Section on Neurology and Neurosurg-ery,2001,28(5):336-339.
13.刘志雄,刘运生。海绵窦的显微解剖及其临床意义[J].国外医学神经病学神经外科分册,2001,28(5):336-339。
14.Ozdogmus O,Saka E,Tulay C,et al.The anatomy of the carotico-clinoid foramen and its relationwith the internal carotid artery[J].SurgRadiol Anat,2003,25(3-4):241-246.
15.Parkinson D.Carotid cavernous fistula:direct repair with preservation of the carotid artery[J].Neurosurg,1973,38(1):99-106.
16.Sobeih MM,Corfas G.Extracellular factors that regulate neuronal migration in the central nervous system.Int J Dev Neurosci,2002,20(3-5):349-357.
17.王海军,王涤字,徐杰.海绵窦内侧壁的应用解剖.解剖学杂志,2004,27(3):304-306。
18.Yasuda A,Campero A,MartinsC,et al.The medial wall of the cavernous sinus:Microsurjical anatomy[J].Neurosurgery,2004,55(1):179-189
19.J Kehrli P,Ali M,Reis M,et 81.AJ.atar,ly and embryology of the lateral sellar comenpartent(cavernous sinus)medial wall[J].Neurol Res,1998,20(4):585-592.
20.Dolenc VV.Relation of the cavernous sinus to the sella,in Anatomy and surgery of the cavernous sinus.Wien,Springer-Verlag,1989,118-130.
21.汪华桥,庞水发,陈增保,等。颈内动脉海绵窦段分支及其临床意义[J]中华显微外科杂志增刊,1999,22(8):49-51。
1. Inoue T, Rhoton AL Jr, Theele D, Barry ME: Surgical approaches to the cavernous sinus: A microsurgical study. Neurosurgery 26: 903-932,1990.
2. Laws ER Jr, Onofrio BM, Pearson BW, McDonald TJ, Dirrenberger RA: Successful management of bilateral carotid-cavernous fistulae with a trans-sphenoidal approach. Neurochirurgia (Stuttg) 27: 93-97, 1984.
3. Parkinson D: Lateral sellar compartment: History and anatomy. J Craniofac Surg 6: 55-68, 1995.
4 .Rhoton AL Jr, Hardy DG, Chambers SM: Microsurgical anatomy and dissection of the sphenoid bone, cavernous sinus and sellar region. Surg Neurol 12: 63-104, 1979.
5. Hashimoto N, Kikuchi H: Transsphenoidal approach to infrasellar tumors involving the cavernous sinus. J Neurosurg 73: 513-517,1990.
6. Krisht A, Barnett DW, Barrow DL, Bonner G: The blood supply of the intracavernous cranial nerves: An anatomic study. Neurosurgery 34: 275-279, 1994.
7. Sekhar LN, Burgess J, Akin O: Anatomical study of the cavernous sinus emphasizing operative approaches and related vascular and neural reconstruction. Neurosurgery 21: 806-889,1987.
8 .Cappabianca P, Alfieri A, Colao A, Ferone D, Lombardi G, de Divitiis E: Endoscopic endonasal transsphenoidal approach: An additional reason in support of surgery in the management of pituitary lesions. Skull Base Surg 9: 109-117,1999.
9. Cappabianca P, Alfieri A, de Divitiis E: Endoscopic endonasal transsphenoidal approach to the sella: Towards functional endoscopic pituitary surgery (FEPS). Minim Invasive Neurosurg 41: 66-73, 1998.
10. Jho HD: Endoscopic surgery of pituitary adenomas, in Krisht AF, Tindall GT (eds): Pituitary Disorders: Comprehensive Management. Baltimore, Lippincott Williams & Wilkins, 1999, pp 389-403.
11. Jho HD: Endoscopy in skull base surgery. Skull Base Surg 9 (Suppl 2): 20-21, 1999(abstr).
12.Jho HD,Carrau RL:Endoscopic endonasal transsphenoidal surgery:Experience with 50 patients.Neurosurg Focus 1:Article 2,1996.
13.Jho HD,Carrau RL:Endoscopic endonasal transsphenoidal surgery:Experience with 50 patients.J Neurosurg 87:44-51,1997.
14.Jho HD,Ha HG:Endoscopic endonasal skull base approach:Part 2-The cavernous sinus.Minim Invasive Neurosurg(in press).
15.Jho HD,Carrau RL,Ko Y:Endoscopic pituitary surgery,in Rengachary SS,Wilkins RH(eds):Neurosurgical Operative Atlas.Park Ridge,AANS,1996,vol 5,pp 1-12.
16.Jho HD,Carrau RL,Ko Y,Daly M:Endoscopic pituitary surgery:An early experience.Surg Neurol 47:213-223,1997.
17.Jho HD,Carrau RL,McLaughlin ML,Somaza SC:Endoscopic transsphenoidal resection of a large chordoma in the posterior fossa.Neurosurg Focus 1:Article 3,1996.
18.Asari KV,Kumar S,Radhakrishnan D:Technique of distortion correction in endoscopic images using a polynomial expansion.Med Biol Eng Comput 37:8-12,1999.
19.Dietemann JL,Kehrli P,Maillot C,Diniz R,Reis M Jr,Neugroschl C,Vinclair L:Is there a dural wall between the cavernous sinus and the pituitary fossa?Anatomical and MRI findings.Neuroradiology 40:627-630,1998.
20.Kawase T,van Loveren H,Keller JT,Tew JM:Meningeal architecture of the cavernous sinus:Clinical and surgical implications.Neurosurgery 39:527-536,1996.
21.王继群,许庚,卜国铉.蝶窦外侧壁的应用解剖[J]中华耳鼻咽喉科杂志,1994;29(3):143-144。
22.Alfieri A,Jho HD.Endoscopic edonasal cavernous sinous surgery:an antomic study[J].neurousurgery,2001;48(4):827-837
23.Sekhar LN,Mφller AR:Operative management of tumors involving the cavernous sinus.J Neurosurg 64:879-889,1986.
24.Inoue T,Rhoton AL Jr,Theele D,Barry ME:Surgical approaches to the cavernous sinus:A microsurgical study.Neurosurgery 26:903-932,1990.
25.陈革,凌锋,杜建新,等.内镜下经鼻蝶入路治疗鞍区病变的解剖学研究[J]中国微侵袭神经外科杂志,2005;10(5)214-217
1.Parkinson D.A surgical approach to the cavernous portion of carotid artery.J Neurosurg,1965,23(5):474-483.
2.Parkinson D.Well-describled anatomy.J Neurosurg.1998,89(5):894-898.
3.Parkinson D.Later sellar compartment:history and anatomy.Crankac Surg,1995,6(1):55-68
4.Kawase T,van Loveren H,Keller JT,et al.Meningeal arch itecture of the cavernous sinus:Clinical and surgical implications.Neurosurgery,1996,39(3):527-534
5.Krist A,Barnett DN,Barrow DL,et al.The blood supply of the intrcavemous cranial nerves:anantomic study.Neurosurgery,1994,3(2):275-279
6吴建东,惠国桢,夏春林.CS内颅神经血液供应显微外科解剖研究.中华神经外科杂志,2001,17(2):95-98
7.Yousry I,Camelio S,Wiesmann M,et al.Detailed Magnetic resonance imaging anatomy of the cisternal segment of the abducent nerve:Dorello,scanal and neurovascul arrelationships and landmards.Neurosurgery,1999,91(2):276-283
8.尹嘉,曹瑞华,丁学华,等.经CS脑神经的显微外科解剖及其临床意义.中国临床解剖学杂志,2002,20(6):421-423
9.Mullan S.Treatment of carotic-caverous fistulas by cavernous sinus occlusion.J Neurosurg,1979,50(2):131-134
10.张保中,薛志广,余新光,等.CS三角的显微外科解剖.军医进修学院学报,1999,20(1):43-45
11.江涛,王忠诚,于春江,等.CS显微外科相关三角解剖学研究.中华神经外科杂志,1999,15(1):45-49
12.EL-Kalling M,et al.Tumors of the lateral wall of the cavernous sinus.J Neurosurg,1992,77:508
13.el-Kaling M,van Loveren H,Keller JT,et al.Tumors of the lateral wall of the cavermous sinus.J Neurosurg.1992,77(4):508-514.
14.Inoue T,Rhoton AL Jr,Theele D,et al.Surgical approaches to the cavernous sinus:A microsurgil study.Neurosurgery,1990,26(6):903-932.
15.TuccarE,UzA,Tekdemirl,et al.Anatomy study of the lateral wall of the cavernous sinus,emphasizing dural construction and neural relation.Neurosurg Rev,2000,32(1):45-48.
16.Mullan S.Treatment of carolid cavernous fistulas by cacvernous sinus occlussion.J Neurosurg,1979,50(2):131-144.
17.Dolenc V.Direct micorsurgical repair of intracacernous vascular lesion.J Neurosurg,1983,58(6):824-831.
18.v Loveren H,Keller JT,El-Kalling M,et al.The Dolenc technique for carernous sinus exploration leadavenic ptosection.J Neurosurg,1991,74(5):837-844.
19.Kawase T,van Loveren H,Keller Jr,et al.Meningeal architecture of the cavernous sinus:Clinical and surgical implications Neurosurgery,1996,39(3):527-536.
20 Hakuba A,Tanaka K,Suznkt,et al.A combined orbitozygomatic infratemporal epidural and subdural approach for lessions involving the entire cavernous sinus.J Neurosurg,1989,71(5):699-704.
21.Seoane A,Rhoton Al Jr,de Oliveia E.Microsurgical anatomy of the dural collar(carondcollar) and rings around the clinoid segment of the internal carotid artery.Neurosurgery,1998,42(6):869-886.
22.Pieper DR,Al-Mefty O.Management of intracranial meningiomas secondarily involving the infratemporal fossa radiograhpic characteristics,pattern of tumor invasson,and surgical implications.Neurosurgery,1999,45(2):231-237.
23.Harsh GR,Sekhar LN.The subtemporal,transcavernous,anterior transperosal approach to the upper brain stem and clivus.J Neurosug,1992,77(5):709-717.
24.Sekhar LN,Schessel DA,Bucur SD,et al.Partical labyrinthectomy petrous apicectomy approach to neoplastic and vascular lesions of the peroelical area.Neurosurger,1999,44(3):537-552.
25.Samu M,Tatagiba M,Carvalbo GA.Restrsigmoid intradural suprameatal approach to Meckel's cave and middle fossa:Surgical technique and outcome.J Neurosurg,2000,92(2):235-241.
26.MacDonald JD,Antonelli P,Day AL.The anterior subtemporal,medial transpetroal appraoch to the upper basilar artery and pontomesencephahc junction.Neurosurgery,1998,43(1):84-89.
27 .Alfien A,Jho HD.Endoscopic endonasal cavernous sinus surgery:an anatomy study.Neurosurgery,2001,48(4):827～837.
28. Sabitl,Schaefer SD,Couldwell WT.Extradural extranasal combined transmaxillary transsphenoidal appraoch to the cavernous sinus:a minimally invasion micorsurgical model.Laryngscope,2000,110(2):286～29.
29. Laws ER Jr, Onofrio BM, Pearson BW, McDonald TJ, Dirrenberger RA: Successful management of bilateral carotid-cavernous fistulae with a trans-sphenoidal approach. Neurosurgery 4:162-167, 1979
30 .Couldwell WT, Weiss MH, Rabb C, Liu JK, Apfelbaum RI, Fukushima T: Variations on the standard transsphenoidal approach to the sellar region, with emphasis on the extended approaches and parasellar approaches: surgical experience in 105 cases. Neurosurgery 55:539-550, 2004
31. Fraioli B, Esposito V, Santoro A, Iannetti G, Giuffre R, Cantore G: Transmaxillo-sphenoidal approach to tumors invading the medial compartment of the cavernous sinus. J Neurosurg 82:63-69,1995
32. Hashimoto N, Kikuchi H: Transsphenoidal approach to infrasellar tumors involving the cavernous sinus. J Neurosurg 73:513-517,1990
33.Jane JA Jr, Thapar K, Kaptain GJ, Maartens N, Laws ER Jr:Pituitary surgery: transsphenoidal approach. Neurosurgery 51:435-444, 2002
34. Kitano M, Taneda M: Extended transsphenoidal approach with submucosal posterior ethmoidectomy for parasellar tumors. Technical note. J Neurosurg 94:999-1004, 2001
35. Sabit I, Schaefer SD, Couldwell WT: Extradural extranasal combined transmaxillary transsphenoidal approach to the cavernous sinus: a minimally invasive microsurgical model. Laryngoscope110:286-291,2000
36 .Weiss MH: The transnasal transsphenoidal approach, in Apuzzo MLJ (ed): Surgery of the Third Ventricle. Baltimore: Williams&Wilkins, 1987, pp 476-494
37 .Yasuda A, Campero A, Martins C, Rhoton AL Jr, Oliveira E,Ribas GC: Microsurgical anatomy and approaches to the cavernous sinus. Neurosurgery 56 (1 Suppl):4-27, 2005
38.Alfieri A,Jho HD:Endoscopic endonasal approaches to the cavernous sinus:surgical approaches.Neurosurgery 49:354-362,2001
39.Cappabianca P,Alfieri A,Thermes S,Buonamassa S,de Divitiis E:Instruments for endoscopic endonasal transsphenoidal surgery.Neurosurgery 45:392-396,1999
40.Cappabianca P,Alfieri A,de Divitiis E,Tschabitscher M:Atlas of Endoscopic Anatomy for Endonasal Intracranial Surgery.New York,Springer-Verlag,2001,pp 134.
41.de Divitiis E,Cappabianca P:Endoscopic endonasal transsphenoidal surgery,in Pickard JD(ed):Advances and Technical Standards in Neurosurgery.New York,Springer Verlag,2002,vol 27,pp 137-177.
42Cappabianca P,Cavallo LM,Mariniello G,de Divitiis O,Becerra Romero ADC,de Divitiis E:Easy sellar reconstruction in endoscopic endonasal transsphenoidal surgery with polyester-silicone dural substitute and fibringlue:Technical note.Neurosurgery 49:473-476,2001.
43.Spaziante R,dc Divitiis E,Cappabianca P:Repair of the sella after trans-sphenoidal surgery,in Schmidek HH(ed):Schmidek and Sweet OperativeNeurosurgical Techniques:Indications,Methods and Results.Philadelphia,W.B.Saunders Co.,2000,vol 1,pp 398-416.
44.de Divitiis E,Cappabianca P,Cavallo LM,Spaziante R:Sellar repair.J Neurosurg 14:861-862,2001(letter).
45.Kaptain GJ,Vincent DA,Sheehan JP,Laws ER Jr:Transsphenoidal approaches for extracapsular resection of midline suprasellar and anterior cranial base lesions.Neurosurgery 49:94-101,2001.
46.Kato T,Sawamura J,Abe H,Nagashima M:Transsphenoidal transtuberculum sellae approach for supradiaphragmatic tumours:Technical note.Acta Neurochir (Wien) 140:715-719,1998.
47.Kim J,Choe I,Bak K,Kim C,Kim N,Yang Y:Transsphenoidal supradia phragmatic intradural approach:Technical note.Minim Invasive Neurosurg 43:33-37,2000.
48. Kouri JG, Chen MY, Watson JC, Oldfield EH: Resection of suprasellar tumors by using a modified transsphenoidal approach. J Neurosurg 92:1028-1035,2000.
49. Mason RB, Nieman LK, Doppman JL, Oldfield EH: Selective excision of adenomas originating in or extending into the pituitary stalk with preservation of pituitary function. J Neurosurg 87:343-351,1997.
50. Jho HD: Endoscopic transsphenoidal surgery, in Schmidek HH (ed):Schmidek and Sweet Operative Neurosurgical Techniques: Indications, Methodsand Results. Philadelphia, W.B. Saunders Co., 2000, vol 1, pp 385-397.
51. Jho HD: Endoscopic endonasal approach to the optic nerve: A technicalnote. Minim Invasive Neurosurg 44:190-193, 2001.
52. Jho HD, Carrau RL, McLaughlin ML, Somaza SC: Endoscopic transsphenoidal resection of a large chordoma in the posterior fossa. Acta Neurochir(Wien) 139:343-348, 1997.
53. Alfieri A, Jho HD: Endoscopic endonasal approaches to the cavernous sinus:Surgical approaches. Neurosurgery 49:354-362, 2001.
54. Alfieri A, Jho HD: Endoscopic endonasal cavernous sinus surgery: Ananatomic study. Neurosurgery 48:827-837, 2001.
55. Spencer WR, Das K, Nwagu C, Wenk E, Schaefer SD, Moscatello A,Couldwell WT: Approaches to the sellar and parasellar region: Anatomic comparison of the microscope versus endoscope. Laryngoscope 109:791-794,1999.
56. Frank G, Pasquini E, Calbucci F: Endoscopic approach to the cavernous sinus via an ethmoido-pterygo-sphenoidal route. Presented at the 5th European Skull Base Society Congress, Copenhagen, Denmark, June 15-17,2001 (additional abstracts, p 009b).
57 .Ausman JL.Philosophy of skull base surgery:a lecture Dr Madjid Sami.Surg Neurol,1997,47(2):154～155.
58. Lovern HR,et al.The dolenc technique for cavernous sinus exploration(cadvaeric prosection).J Neurosurg, 1991,74:837
59.Wascher TM,et al.Improved transdural expoure and temporary occlusion of the petrous carotid for cavernous sinus.Surgery,osurg, 1002,78:834
60.Sen CN,et al.Direct vain graft reconstruction of the cavernous sinus,petrous and upper cervical internal carotid artery:lessions icarned from 30 cases.Neurosurg 1992,30:732
61.Sekhar LN et al.Reconstruction of the third through sixthe cranial nerver during cavernous sinus surgery.J Neurosurg,1992,76,935
62.Al-Mefty O,et al.Zygoma approach to skull-base lesion.J Neurosurgery 1991,28:99.
63.Sekhar LN,et al.In Al-Mefty O(ed):Meningioma New York,Rave -n,1991:445,Duma CM,et al.Stereocactic radiosurgery of cavernous sinus micorgiomas as a addition or alternarive to micorsurgery.Neuros -urg,1993,32:669.
64.Sekhar LN,et al.In Al-Mefty O(ed):Meningioma New York,Raven,1991:445
2.Tuccar E,Uz A,Tekdemir I,et al.Anatomical study of the lateral wall of the cavernous sinus,emphasizing dural construction and neural relation[J].Neurosurg Rev,2000,23(1):45-48.
3.江涛,王忠诚,于春江,等。CS显微外科相关三角解剖学研究[J].中华神经外科杂志,1999,15(1):45-49.
4.Inoue T,Rhoton AL Jr,Theele D,et al.Surgical approaches to the cavernous sinus:A microsurgical study[J].Neurosurgery,1990,26(6):903-932.
5.Bedford MA.The cavernous sinus[J].Br J Ophthal,1966,50:41-4
6.Taptas JN.The so-called cavernous sinus:a review of the comtroversyand its implications for neurosurgeons[J].Neurosurg,1982,11(5):712-717.
7.Cappabianca P,Cavallo LM,Mariniello G,de Divitiis O,Becerra Romero ADC,de Divitiis E:Easy sellar reconstruction in endoscopic endonasal transsphenoidal surgery with polyester-silicone dural substitute and fibringlue:Technical note.Neurosurgery 49:473-476,2001.
8.Parksin D.A surgical approach to the cavernous portion of thecarotid artery:anatomical studies and case report[J].J Neurosurg,1965,23(5):474-483.
9.Parkinson D.Lateral sellar compartment:history and anatomy[J].J Craniofae Surg,1995,6(1):55-68.
10.Lang J,Kageyama I.Clinical anatomy of the blood spaces andblood vessels surrounding the siphon of the internal carotid artery[J].Acta Anat,1990,139:320-325.
11.Weninger WJ,Streicher J,Muller CB.Anatomical compartmentof the parasellar region:adipose tissue bodies represent intracranial continuations of extracranial spases[J].J Anat,1997,191(pt2):269-275.
12.Liu ZHX,Liu YSH.Microanatomy of cavernous sinus and its clinicalimport-ance [J].Foreign medical Sciences Section on Neurology and Neurosurg-ery,2001,28(5):336-339.
13.刘志雄,刘运生。海绵窦的显微解剖及其临床意义[J].国外医学神经病学神经外科分册,2001,28(5):336-339。
14.Ozdogmus O,Saka E,Tulay C,et al.The anatomy of the carotico-clinoid foramen and its relationwith the internal carotid artery[J].SurgRadiol Anat,2003,25(3-4):241-246.
15.Parkinson D.Carotid cavernous fistula:direct repair with preservation of the carotid artery[J].Neurosurg,1973,38(1):99-106.
16.Sobeih MM,Corfas G.Extracellular factors that regulate neuronal migration in the central nervous system.Int J Dev Neurosci,2002,20(3-5):349-357.
17.王海军,王涤字,徐杰.海绵窦内侧壁的应用解剖.解剖学杂志,2004,27(3):304-306。
18.Yasuda A,Campero A,MartinsC,et al.The medial wall of the cavernous sinus:Microsurjical anatomy[J].Neurosurgery,2004,55(1):179-189
19.J Kehrli P,Ali M,Reis M,et 81.AJ.atar,ly and embryology of the lateral sellar comenpartent(cavernous sinus)medial wall[J].Neurol Res,1998,20(4):585-592.
20.Dolenc VV.Relation of the cavernous sinus to the sella,in Anatomy and surgery of the cavernous sinus.Wien,Springer-Verlag,1989,118-130.
21.汪华桥,庞水发,陈增保,等。颈内动脉海绵窦段分支及其临床意义[J]中华显微外科杂志增刊,1999,22(8):49-51。
1. Inoue T, Rhoton AL Jr, Theele D, Barry ME: Surgical approaches to the cavernous sinus: A microsurgical study. Neurosurgery 26: 903-932,1990.
2. Laws ER Jr, Onofrio BM, Pearson BW, McDonald TJ, Dirrenberger RA: Successful management of bilateral carotid-cavernous fistulae with a trans-sphenoidal approach. Neurochirurgia (Stuttg) 27: 93-97, 1984.
3. Parkinson D: Lateral sellar compartment: History and anatomy. J Craniofac Surg 6: 55-68, 1995.
4 .Rhoton AL Jr, Hardy DG, Chambers SM: Microsurgical anatomy and dissection of the sphenoid bone, cavernous sinus and sellar region. Surg Neurol 12: 63-104, 1979.
5. Hashimoto N, Kikuchi H: Transsphenoidal approach to infrasellar tumors involving the cavernous sinus. J Neurosurg 73: 513-517,1990.
6. Krisht A, Barnett DW, Barrow DL, Bonner G: The blood supply of the intracavernous cranial nerves: An anatomic study. Neurosurgery 34: 275-279, 1994.
7. Sekhar LN, Burgess J, Akin O: Anatomical study of the cavernous sinus emphasizing operative approaches and related vascular and neural reconstruction. Neurosurgery 21: 806-889,1987.
8 .Cappabianca P, Alfieri A, Colao A, Ferone D, Lombardi G, de Divitiis E: Endoscopic endonasal transsphenoidal approach: An additional reason in support of surgery in the management of pituitary lesions. Skull Base Surg 9: 109-117,1999.
9. Cappabianca P, Alfieri A, de Divitiis E: Endoscopic endonasal transsphenoidal approach to the sella: Towards functional endoscopic pituitary surgery (FEPS). Minim Invasive Neurosurg 41: 66-73, 1998.
10. Jho HD: Endoscopic surgery of pituitary adenomas, in Krisht AF, Tindall GT (eds): Pituitary Disorders: Comprehensive Management. Baltimore, Lippincott Williams & Wilkins, 1999, pp 389-403.
11. Jho HD: Endoscopy in skull base surgery. Skull Base Surg 9 (Suppl 2): 20-21, 1999(abstr).
12.Jho HD,Carrau RL:Endoscopic endonasal transsphenoidal surgery:Experience with 50 patients.Neurosurg Focus 1:Article 2,1996.
13.Jho HD,Carrau RL:Endoscopic endonasal transsphenoidal surgery:Experience with 50 patients.J Neurosurg 87:44-51,1997.
14.Jho HD,Ha HG:Endoscopic endonasal skull base approach:Part 2-The cavernous sinus.Minim Invasive Neurosurg(in press).
15.Jho HD,Carrau RL,Ko Y:Endoscopic pituitary surgery,in Rengachary SS,Wilkins RH(eds):Neurosurgical Operative Atlas.Park Ridge,AANS,1996,vol 5,pp 1-12.
16.Jho HD,Carrau RL,Ko Y,Daly M:Endoscopic pituitary surgery:An early experience.Surg Neurol 47:213-223,1997.
17.Jho HD,Carrau RL,McLaughlin ML,Somaza SC:Endoscopic transsphenoidal resection of a large chordoma in the posterior fossa.Neurosurg Focus 1:Article 3,1996.
18.Asari KV,Kumar S,Radhakrishnan D:Technique of distortion correction in endoscopic images using a polynomial expansion.Med Biol Eng Comput 37:8-12,1999.
19.Dietemann JL,Kehrli P,Maillot C,Diniz R,Reis M Jr,Neugroschl C,Vinclair L:Is there a dural wall between the cavernous sinus and the pituitary fossa?Anatomical and MRI findings.Neuroradiology 40:627-630,1998.
20.Kawase T,van Loveren H,Keller JT,Tew JM:Meningeal architecture of the cavernous sinus:Clinical and surgical implications.Neurosurgery 39:527-536,1996.
21.王继群,许庚,卜国铉.蝶窦外侧壁的应用解剖[J]中华耳鼻咽喉科杂志,1994;29(3):143-144。
22.Alfieri A,Jho HD.Endoscopic edonasal cavernous sinous surgery:an antomic study[J].neurousurgery,2001;48(4):827-837
23.Sekhar LN,Mφller AR:Operative management of tumors involving the cavernous sinus.J Neurosurg 64:879-889,1986.
24.Inoue T,Rhoton AL Jr,Theele D,Barry ME:Surgical approaches to the cavernous sinus:A microsurgical study.Neurosurgery 26:903-932,1990.
25.陈革,凌锋,杜建新,等.内镜下经鼻蝶入路治疗鞍区病变的解剖学研究[J]中国微侵袭神经外科杂志,2005;10(5)214-217
1.Parkinson D.A surgical approach to the cavernous portion of carotid artery.J Neurosurg,1965,23(5):474-483.
2.Parkinson D.Well-describled anatomy.J Neurosurg.1998,89(5):894-898.
3.Parkinson D.Later sellar compartment:history and anatomy.Crankac Surg,1995,6(1):55-68
4.Kawase T,van Loveren H,Keller JT,et al.Meningeal arch itecture of the cavernous sinus:Clinical and surgical implications.Neurosurgery,1996,39(3):527-534
5.Krist A,Barnett DN,Barrow DL,et al.The blood supply of the intrcavemous cranial nerves:anantomic study.Neurosurgery,1994,3(2):275-279
6吴建东,惠国桢,夏春林.CS内颅神经血液供应显微外科解剖研究.中华神经外科杂志,2001,17(2):95-98
7.Yousry I,Camelio S,Wiesmann M,et al.Detailed Magnetic resonance imaging anatomy of the cisternal segment of the abducent nerve:Dorello,scanal and neurovascul arrelationships and landmards.Neurosurgery,1999,91(2):276-283
8.尹嘉,曹瑞华,丁学华,等.经CS脑神经的显微外科解剖及其临床意义.中国临床解剖学杂志,2002,20(6):421-423
9.Mullan S.Treatment of carotic-caverous fistulas by cavernous sinus occlusion.J Neurosurg,1979,50(2):131-134
10.张保中,薛志广,余新光,等.CS三角的显微外科解剖.军医进修学院学报,1999,20(1):43-45
11.江涛,王忠诚,于春江,等.CS显微外科相关三角解剖学研究.中华神经外科杂志,1999,15(1):45-49
12.EL-Kalling M,et al.Tumors of the lateral wall of the cavernous sinus.J Neurosurg,1992,77:508
13.el-Kaling M,van Loveren H,Keller JT,et al.Tumors of the lateral wall of the cavermous sinus.J Neurosurg.1992,77(4):508-514.
14.Inoue T,Rhoton AL Jr,Theele D,et al.Surgical approaches to the cavernous sinus:A microsurgil study.Neurosurgery,1990,26(6):903-932.
15.TuccarE,UzA,Tekdemirl,et al.Anatomy study of the lateral wall of the cavernous sinus,emphasizing dural construction and neural relation.Neurosurg Rev,2000,32(1):45-48.
16.Mullan S.Treatment of carolid cavernous fistulas by cacvernous sinus occlussion.J Neurosurg,1979,50(2):131-144.
17.Dolenc V.Direct micorsurgical repair of intracacernous vascular lesion.J Neurosurg,1983,58(6):824-831.
18.v Loveren H,Keller JT,El-Kalling M,et al.The Dolenc technique for carernous sinus exploration leadavenic ptosection.J Neurosurg,1991,74(5):837-844.
19.Kawase T,van Loveren H,Keller Jr,et al.Meningeal architecture of the cavernous sinus:Clinical and surgical implications Neurosurgery,1996,39(3):527-536.
20 Hakuba A,Tanaka K,Suznkt,et al.A combined orbitozygomatic infratemporal epidural and subdural approach for lessions involving the entire cavernous sinus.J Neurosurg,1989,71(5):699-704.
21.Seoane A,Rhoton Al Jr,de Oliveia E.Microsurgical anatomy of the dural collar(carondcollar) and rings around the clinoid segment of the internal carotid artery.Neurosurgery,1998,42(6):869-886.
22.Pieper DR,Al-Mefty O.Management of intracranial meningiomas secondarily involving the infratemporal fossa radiograhpic characteristics,pattern of tumor invasson,and surgical implications.Neurosurgery,1999,45(2):231-237.
23.Harsh GR,Sekhar LN.The subtemporal,transcavernous,anterior transperosal approach to the upper brain stem and clivus.J Neurosug,1992,77(5):709-717.
24.Sekhar LN,Schessel DA,Bucur SD,et al.Partical labyrinthectomy petrous apicectomy approach to neoplastic and vascular lesions of the peroelical area.Neurosurger,1999,44(3):537-552.
25.Samu M,Tatagiba M,Carvalbo GA.Restrsigmoid intradural suprameatal approach to Meckel's cave and middle fossa:Surgical technique and outcome.J Neurosurg,2000,92(2):235-241.
26.MacDonald JD,Antonelli P,Day AL.The anterior subtemporal,medial transpetroal appraoch to the upper basilar artery and pontomesencephahc junction.Neurosurgery,1998,43(1):84-89.
27 .Alfien A,Jho HD.Endoscopic endonasal cavernous sinus surgery:an anatomy study.Neurosurgery,2001,48(4):827～837.
28. Sabitl,Schaefer SD,Couldwell WT.Extradural extranasal combined transmaxillary transsphenoidal appraoch to the cavernous sinus:a minimally invasion micorsurgical model.Laryngscope,2000,110(2):286～29.
29. Laws ER Jr, Onofrio BM, Pearson BW, McDonald TJ, Dirrenberger RA: Successful management of bilateral carotid-cavernous fistulae with a trans-sphenoidal approach. Neurosurgery 4:162-167, 1979
30 .Couldwell WT, Weiss MH, Rabb C, Liu JK, Apfelbaum RI, Fukushima T: Variations on the standard transsphenoidal approach to the sellar region, with emphasis on the extended approaches and parasellar approaches: surgical experience in 105 cases. Neurosurgery 55:539-550, 2004
31. Fraioli B, Esposito V, Santoro A, Iannetti G, Giuffre R, Cantore G: Transmaxillo-sphenoidal approach to tumors invading the medial compartment of the cavernous sinus. J Neurosurg 82:63-69,1995
32. Hashimoto N, Kikuchi H: Transsphenoidal approach to infrasellar tumors involving the cavernous sinus. J Neurosurg 73:513-517,1990
33.Jane JA Jr, Thapar K, Kaptain GJ, Maartens N, Laws ER Jr:Pituitary surgery: transsphenoidal approach. Neurosurgery 51:435-444, 2002
34. Kitano M, Taneda M: Extended transsphenoidal approach with submucosal posterior ethmoidectomy for parasellar tumors. Technical note. J Neurosurg 94:999-1004, 2001
35. Sabit I, Schaefer SD, Couldwell WT: Extradural extranasal combined transmaxillary transsphenoidal approach to the cavernous sinus: a minimally invasive microsurgical model. Laryngoscope110:286-291,2000
36 .Weiss MH: The transnasal transsphenoidal approach, in Apuzzo MLJ (ed): Surgery of the Third Ventricle. Baltimore: Williams&Wilkins, 1987, pp 476-494
37 .Yasuda A, Campero A, Martins C, Rhoton AL Jr, Oliveira E,Ribas GC: Microsurgical anatomy and approaches to the cavernous sinus. Neurosurgery 56 (1 Suppl):4-27, 2005
38.Alfieri A,Jho HD:Endoscopic endonasal approaches to the cavernous sinus:surgical approaches.Neurosurgery 49:354-362,2001
39.Cappabianca P,Alfieri A,Thermes S,Buonamassa S,de Divitiis E:Instruments for endoscopic endonasal transsphenoidal surgery.Neurosurgery 45:392-396,1999
40.Cappabianca P,Alfieri A,de Divitiis E,Tschabitscher M:Atlas of Endoscopic Anatomy for Endonasal Intracranial Surgery.New York,Springer-Verlag,2001,pp 134.
41.de Divitiis E,Cappabianca P:Endoscopic endonasal transsphenoidal surgery,in Pickard JD(ed):Advances and Technical Standards in Neurosurgery.New York,Springer Verlag,2002,vol 27,pp 137-177.
42Cappabianca P,Cavallo LM,Mariniello G,de Divitiis O,Becerra Romero ADC,de Divitiis E:Easy sellar reconstruction in endoscopic endonasal transsphenoidal surgery with polyester-silicone dural substitute and fibringlue:Technical note.Neurosurgery 49:473-476,2001.
43.Spaziante R,dc Divitiis E,Cappabianca P:Repair of the sella after trans-sphenoidal surgery,in Schmidek HH(ed):Schmidek and Sweet OperativeNeurosurgical Techniques:Indications,Methods and Results.Philadelphia,W.B.Saunders Co.,2000,vol 1,pp 398-416.
44.de Divitiis E,Cappabianca P,Cavallo LM,Spaziante R:Sellar repair.J Neurosurg 14:861-862,2001(letter).
45.Kaptain GJ,Vincent DA,Sheehan JP,Laws ER Jr:Transsphenoidal approaches for extracapsular resection of midline suprasellar and anterior cranial base lesions.Neurosurgery 49:94-101,2001.
46.Kato T,Sawamura J,Abe H,Nagashima M:Transsphenoidal transtuberculum sellae approach for supradiaphragmatic tumours:Technical note.Acta Neurochir (Wien) 140:715-719,1998.
47.Kim J,Choe I,Bak K,Kim C,Kim N,Yang Y:Transsphenoidal supradia phragmatic intradural approach:Technical note.Minim Invasive Neurosurg 43:33-37,2000.
48. Kouri JG, Chen MY, Watson JC, Oldfield EH: Resection of suprasellar tumors by using a modified transsphenoidal approach. J Neurosurg 92:1028-1035,2000.
49. Mason RB, Nieman LK, Doppman JL, Oldfield EH: Selective excision of adenomas originating in or extending into the pituitary stalk with preservation of pituitary function. J Neurosurg 87:343-351,1997.
50. Jho HD: Endoscopic transsphenoidal surgery, in Schmidek HH (ed):Schmidek and Sweet Operative Neurosurgical Techniques: Indications, Methodsand Results. Philadelphia, W.B. Saunders Co., 2000, vol 1, pp 385-397.
51. Jho HD: Endoscopic endonasal approach to the optic nerve: A technicalnote. Minim Invasive Neurosurg 44:190-193, 2001.
52. Jho HD, Carrau RL, McLaughlin ML, Somaza SC: Endoscopic transsphenoidal resection of a large chordoma in the posterior fossa. Acta Neurochir(Wien) 139:343-348, 1997.
53. Alfieri A, Jho HD: Endoscopic endonasal approaches to the cavernous sinus:Surgical approaches. Neurosurgery 49:354-362, 2001.
54. Alfieri A, Jho HD: Endoscopic endonasal cavernous sinus surgery: Ananatomic study. Neurosurgery 48:827-837, 2001.
55. Spencer WR, Das K, Nwagu C, Wenk E, Schaefer SD, Moscatello A,Couldwell WT: Approaches to the sellar and parasellar region: Anatomic comparison of the microscope versus endoscope. Laryngoscope 109:791-794,1999.
56. Frank G, Pasquini E, Calbucci F: Endoscopic approach to the cavernous sinus via an ethmoido-pterygo-sphenoidal route. Presented at the 5th European Skull Base Society Congress, Copenhagen, Denmark, June 15-17,2001 (additional abstracts, p 009b).
57 .Ausman JL.Philosophy of skull base surgery:a lecture Dr Madjid Sami.Surg Neurol,1997,47(2):154～155.
58. Lovern HR,et al.The dolenc technique for cavernous sinus exploration(cadvaeric prosection).J Neurosurg, 1991,74:837
59.Wascher TM,et al.Improved transdural expoure and temporary occlusion of the petrous carotid for cavernous sinus.Surgery,osurg, 1002,78:834
60.Sen CN,et al.Direct vain graft reconstruction of the cavernous sinus,petrous and upper cervical internal carotid artery:lessions icarned from 30 cases.Neurosurg 1992,30:732
61.Sekhar LN et al.Reconstruction of the third through sixthe cranial nerver during cavernous sinus surgery.J Neurosurg,1992,76,935
62.Al-Mefty O,et al.Zygoma approach to skull-base lesion.J Neurosurgery 1991,28:99.
63.Sekhar LN,et al.In Al-Mefty O(ed):Meningioma New York,Rave -n,1991:445,Duma CM,et al.Stereocactic radiosurgery of cavernous sinus micorgiomas as a addition or alternarive to micorsurgery.Neuros -urg,1993,32:669.
64.Sekhar LN,et al.In Al-Mefty O(ed):Meningioma New York,Raven,1991:445