ABSTRACT
INTRODUCCIÓN: El entrenamiento en la disección de los senos paranasales y la base de cráneo es esencial para el conocimiento anatómico y la correcta aplicación de las técnicas quirúrgicas. La visualización tridimensional de la anatomía endoscópica de la base de cráneo mejora la orientación espacial y permite la percepción de profundidad. OBJETIVO: Mostrar la anatomía endoscópica de la base de cráneo basándose en la técnica tridimensional. MÉTODOS: Realizamos disección endoscópica endonasal en especímenes cadavéricos fijados con formol y con la técnica de Thiel, ambos con inyección intravascular de colorantes. Los abordajes fueron realizados con endoscopios convencionales 2D. Posteriormente aplicamos la técnica 3D anaglífica para ilustrar las figuras en 3D. RESULTADOS: Se ilustran las más importantes estructuras y referencias anatómicas de la región selar desde la perspectiva endonasal endoscópica en 3D. CONCLUSIÓN: La base del cráneo está compuesta por complejas estructuras óseas y neurovasculares. La experiencia con la disección en cadáver es crucial para comprender la anatomía y desarrollar habilidades quirúrgicas. La visualización 3D representa una útil herramienta para comprender la anatomía de la base de cráneo
INTRODUCTION: Training in dissection of the paranasal sinuses and the skull base is essential for anatomical understanding and correct surgical techniques. Three-dimensional (3D) visualisation of endoscopic skull base anatomy increases spatial orientation and allows depthperception. OBJECTIVE: To show endoscopic skull base anatomy based on the 3D technique. METHODS: We performed endoscopic dissection in cadaveric specimens fixed with formalin and with the Thiel technique, both prepared using intravascular injection of coloured material. Endonasal approaches were performed with conventional 2D endoscopes. Then we applied the 3D anaglyph technique to illustrate the pictures in 3D. RESULTS: The mostimportant anatomical structures and landmarks of the sellar region underendonasal endoscopic vision are illustrated in 3D images. CONCLUSION: The skull base consists of complex bony and neurovascular structures. Experience with cadaver dissection is essential to understand complex anatomy and developsurgical skills. A 3D view constitutes a useful tool for understanding skull base anatomy
Subject(s)
Humans , Skull Base/anatomy & histology , Imaging, Three-Dimensional , Endoscopy , Stereotaxic Techniques , Brain Mapping/methodsABSTRACT
INTRODUCTION: Training in dissection of the paranasal sinuses and the skull base is essential for anatomical understanding and correct surgical techniques. Three-dimensional (3D) visualisation of endoscopic skull base anatomy increases spatial orientation and allows depth perception. OBJECTIVE: To show endoscopic skull base anatomy based on the 3D technique. METHODS: We performed endoscopic dissection in cadaveric specimens fixed with formalin and with the Thiel technique, both prepared using intravascular injection of coloured material. Endonasal approaches were performed with conventional 2D endoscopes. Then we applied the 3D anaglyph technique to illustrate the pictures in 3D. RESULTS: The most important anatomical structures and landmarks of the sellar region under endonasal endoscopic vision are illustrated in 3D images. CONCLUSION: The skull base consists of complex bony and neurovascular structures. Experience with cadaver dissection is essential to understand complex anatomy and develop surgical skills. A 3D view constitutes a useful tool for understanding skull base anatomy.
Subject(s)
Endoscopy/methods , Imaging, Three-Dimensional , Skull Base/anatomy & histology , Cadaver , Depth Perception , Dissection , Humans , Nose , Paranasal Sinuses/anatomy & histologyABSTRACT
We report a technical variation of the endoscopic endonasal approach to the sellar and suprasellar regions which relies on the use of a 45-degree angled endoscope. The so-called "infrasellar approach" aims at excising lesions situated within the intermediate and posterior lobes of the pituitary gland without damaging the anterior lobe, thus potentially minimizing endocrinological morbidity. In this regard the endoscopic infrasellar approach might be advantageous in selected cases when compared with the traditional transsphenoidal approach with the microscope. We describe the technique and illustrate it with representative clinical cases.
