Applied anatomy of the endoscopic endonasal approach to the ventral middle-lower part of clivus / 中国医师杂志

Objective To establish the surgical landmarks of the endoscopic endonasal approach to the ventral region of middle-lower part of clivus and provide anatomic basis. Methods Twenty 10% formalin-fixed intact adult head specimens were used to dissect and observe the anatomic feature of this access in order to establish the surgical landmarks of the approach, and some relative anatomic data were measured. Five fresh and intact head specimens injected with colored latex were used, and completely analogical operation via endoscopic endonasal approach to the middle-lower part of clivus was performed in all cases. Results Anatomic landmarks of the approach included middle turbinate, choana narium, eustachian tube ostium, nasopharynx mucosa, longus capitis and longus colli, pharyngeal tubercle, and basi-on. To expose the ventral region of middle-lower part of clivus completely, the shortest distance was ( 89.60 ± 2. 52) mm. The ranges of stripping the inferior wall of sphenoid sinus and the lower clivus were bounded by pterygoid canal and foramen lacerum, and the distances from the median line were (9. 37 ± 0.59) mm and (10. 75 ± 0. 63 ) mm, respectively. Conclusions The structures of the ventral middle-lower part of clivus can be revealed sufficiently via an endoscopic endonasal approach.

THE DIAGNOSIS AND ENDOVASCULAR TREATMENT FOR THE INTRACRANIAL DURAL AND CEREBRAL ARTERIOVENOUS MALFORMATIONS / 解放军医学杂志

Objective To study the angiographic characteristics of congenital intracranial dural and cerebral arteriovenous malformations, and their relationship to the structural characteristics and clinical feature. Methods The clinical histories, cerebral angiograms, and endovascular treatment of 52 cases of the dural and cerebral arteriovenous malformations were analyzed. Results All 52 patients were treated successfully with interventional therapy with introduction of intravascular emboli through microcatheters. In 2 patients, surgical excision was performed after embolism. In another 4 patients, X-ray knife treatment was carried out. Seventeen patients resumed their work, comprising 44.7% of all patients, and in 16 patients symptoms of epilepsy or head ache were markely improved, comprising 42.1% of the group. Conclusion It is important to study structural characteristics with angiograms for successful treatment of congenital artero-venous anomalies of the brain. [HS(1*2/3]