[The study of microdissection of endoscopic transnasal surgery in the sphenopalatine foramen].

OBJECTIVE: To provide anatomy evidence for endoscopic transnasal surgery in the sphenopalatine foramen by measuring and dissecting corpses. METHOD: The position, shape, size and their correlational data of sphenopalatine foramen of 40 sides skulls in adults were measured. RESULT: Classification of the sphenopalatine foramen were as three types: I 35%; II 5%; III 60%. The mean distance from upper edge of the sphenopalatine foramen to the base of the sphenopalatine sinus was male (1.75 +/- 1.10) mm, female (1.13 +/- 0.55) mm, and to the apertura sphenopalatine sinus was male (9.80 +/- 3.27) mm, female (8.30 +/- 3.45) mm. The mean distance from the posterior edge of the sphenopalatine foramen to the rhinopharynx was male (11.12 +/- 3.30) mm, female (10.85 +/- 3.12) mm. The mean distance from the anterior edge of the sphenopalatine foramen to the apertura maxillaris was male (18.50 +/- 6.80) mm, female (14.57 +/- 5.07) mm, and to the apex of nose was male (69.54 +/- 6.98) mm, female (66.57 +/- 5.07) mm, and to the nasospinale was male (56.69 +/- 5.70) mm, female (53.25 +/- 8.80) mm. The horizontal diameter of the sphenopalatine foramen was female (4.61 +/- 1.80) mm, male (5.12 +/- 2.05) mm. The vertical diameter was male (5.37 +/- 2.67) mm, female (0.35 +/- 0.07) mm. The surface diameter of the sphenopalatine artery and nerves was male (2.12 +/- 0.66) mm, female (1.61 +/- 0.70) mm, and male (0.65 +/- 0.49) mm, female (0.35 +/- 0.07) mm. The mean angle from the sphenopalatine foramen to the horizontal plate of palatine bone was male (22.83 +/- 4.71) degrees, female (22.73 +/- 3.81) degrees. Nasal lateral walls were controlled by lateral posterior nasal arteries and nerves, which were classified into three types: I 70%, II 20%, III 10%. CONCLUSION: The observation and survey about the sphenopalatine foramen will supply clinic with anatomy homological.

[The anatomic study of chyle leakage due to operation on abdominal region].

OBJECTIVE: To provide morphological basis for chyle leakage due to operation on upper abdomen or retroperitoneum region. METHODS: The original part of thoracic duct, cisterna chyle, intestinal trunk, left and right lumbar trunks were examined in 32 adult cadavers. RESULTS: (1) The occurrence rate of cisterna chili was 22% (7 cases), among which 4 cases were oval, 3 cases were triangle. The cisterna chyle was (24 +/- 6) mm in length; the width of middle part was (4.1 +/- 0.9) mm. It was located to the right of midline at the level between the twelfth thoracic vertebral body and the second lumbar vertebral body anteriorly. (2) The original part of thoracic duct was (2.8 +/- 0.7) mm in diameter. The confluence form of thoracic duct included: left lumbar trunk and intestinal trunk united to form the common trunk first, right lumbar trunk then joined the common trunk (9 cases, 36%); right lumbar trunk and intestinal trunk united to form the common trunk first, left lumbar trunk then joined the common trunk (8 cases, 32%); left and right lumbar trunk united to form the common trunk first, intestinal trunk then joined the common trunk (4 cases, 16%); left, right lumbar trunk and intestinal trunk joined together (3 cases, 12%). (3) The intestinal trunk was (36 +/- 15) mm in length. It ascended on the left of descending aorta, superior to the left renal artery, crossed the second lumbar vertebra anteriorly, and joined left or right lumbar trunk to form common trunk, which extended to the cisterna chili or thoracic duct to the right of lumbar vertebra. (4) The lengths of left and right lumbar trunks were (107 +/- 24) mm and (111 +/- 18) mm, the external diameters of origins were (1.7 +/- 0.4) mm and (1.9 +/- 0.4) mm, and the external diameters of terminations were (2.2 +/- 0.6) mm and (2.2 +/- 0.5) mm, respectively. CONCLUSION: The larger lymph tubes should be protected emphatically in the relevant region when dissecting the root of celiac and superior mesenteric artery and the termination of inferior mesenteric vein during abdominal operation.

[Impact of ligation of vertebral artery on function of central nervous system, an experimental study].

OBJECTIVE: To study the impact of ligation of bilateral vertebral arteries on the function of central nervous system. METHODS: Twenty dogs underwent ligation of bilateral vertebral arteries at the level of C4 approximately C5 and then were divided into 4 groups, 5 in each: E1 group (killed in one day after the operation), E7 (killed on the 7(th) day postoperatively), E28 (killed on the 28(th) day postoperatively), and control group. Scoring of the function of central nervous system was conducted after awakening from anaesthesia and before being killed according ro modified Tarlov method. Cortical somatosense evoked potential (CSEP), and motor evoked potential (MEP) were examined by electromyograph. CT, MRI, and magnetic resonance angiography (MRA) of the cervical vertebrae were conducted before the dogs were killed. Histological examination of the spinal cord and brain was made and microangiography was performed. RESULTS: The myodynamia, gait, and reflex returned to normal 2 approximately 3 days after the operation with the Tarlov score of 6 for all dogs. Imaging examination and histological examination showed no abnormality, including ischemic injury in posterior inferior lobe of cerebellum. CONCLUSION: Internal carotid artery compensates for the blood obstruction of the vertebral artery in a short time. Cerebral ischemia caused by compression of the vertebral artery is not the main pathomechanism of cervical spondylotic arteriopathy. Microcirculation of human cervical cord can be mimicked in dog model segmentally.