| Objective：The anterior clinoic process is a door and sign which is entered the regionof paraclinoid of frontolateral approach. It is also bony projection which the lessersphenoid wing extends medioposteriorly and ACP are also the protecting sign of theophth A and ICA. Then ACP has important anatomical significance. For the importantarea, The consideration on how to remove totally of the lesions in this area is difficultand become the hotspot and difficulty point in recent several years.To get Chinesedata of individual, to provide direct anatomical diagrams of microsurgery andimaging as well as the detailed anatomical parameters for clinical operation, and moreimportant, to improve the operative erects of the lesions in this area. We design andcarry through this study to get data of individual anatomical relations of bones, nevers,vessels and duramater in the areas of ACP and its adjacent area by statistics andanalysis.Methods：Eight cases (16sides) Chinese adult cadaver heads fixed by10％formalin.Age and sex couldnot be exactly judged. In order to identify arteries and veins, tomaintain the caliber of blood vessels normal, and to improve photo quality, red latexwas injected into arterial systems and blue latex was injected into venous systems.Ten dry Chinese adults skulls were used to observe and measure osseous structure.Frontotemporal-orbitozygomatic approach is the most representative anterolateralapproach. The approach was studied in detail. Under microscope, samples weredissected laye by layer according to operative approaches. Referring to imaginganatomy, measured the anatomical structures accurately and took photos, applicationof clinical operative approaches was studied comparison. All date were statisticallyprocessed and presented in the mean(range of measured value) style.Results：1. The anterior clinoid process is a posterior and medial continuation, next toSOF on anterior lateral, next to lesser wing of the sphenoid bone on anterior lateral,next to optic canal on anterior and be joined with optic strut, ICA pass by ACP internal, carvernous sinus on ACP lateral side.The shape of ACP was pyramidal. Thelength width and thickness were9.29±1.20(7.48-12.07) mm,12.15±2.16(8.97-17.51)mm,5.21±1.15(3.16-7.78) mm. The anterior clinoid process and the optic columnwere removed during the operation. Notice the composition of the surroundingimportant tissues.2. The clinoid process interspace was an artificial taper lacuna after grinding theanterior clinoid process, which related to the composition, range and edge of theanterior clinoid process and the surrounding tissues. This interspace influenced theinvolved microsurgical procedure. The space of clinoid process could been influencedby the relationship of ICA and ACP. The type of A was the largest and it was benefitfor operation. The length of upper, inferior, medial, lateral sides and the height ofclinoid process were9.32±0.95(8.60-12.02) mm,5.32±1.29(2.60-7.02) mm,7.70±3.37(4.02-16.90) mm,11.18±2.90(4.02-14.10) mm and10.05±1.40(8.02-12.90)mm.3. The both the sides combined of mean of measurement±standard deviation isas follows before and after anterior clinoidectomy. The length of optic nerve were8.81±2.47(4.31-12.83) and20.41±2.68(15.85-24.66) mm, The length of ICA were9.60±2.70(4.73-13.98) and13.79±1.76(9.11-15.32) mm, The width of the spacebetween optic nerve and internal carotid artery were4.26±1.31(2.64-7.53) and11.27±2.39(6.29-14.20) mm, The width of the space between ICA and oculomotornerve were7.21±2.57(3.53-12.86) and9.68±2.56(4.49-13.81) mm.4. The length of superior and inferior wall of the optic canal was8.20±1.20(6.5-10.29)mm,5.91±3.20(1.40-12.61)mm, and the distance from skull internal,external foramen were12.63±3.01(7.99-17.17)mm and23.66±3.28(17.13-29.31)mm.5. A11nerves through the cavernous sinus and the ophthalmic vein entered theorbit via the superior orbit fissure, which was divided by the tendon ring into threeareas, the lateral, middle and inferior.The cranial nerves and vessels via the superiororbital fissure, among which the inferior branch of the oculomotor nerve was thethickest and the lacrimal nerve was the thinnest, had constant neighboring location.6.The clinoid segment of the ICA is between the distal dural ring and the proximal dural ring and there existed a venous plexus intersapce of the clinoidprocess betweenthe vessel wall of the clinoid process part of the internal carotidartery and the periostea. The clinoid process part of the internal carotid artery must bea structure within the cavernous sinus.Conclusions:The space of clinoid process which was formed after anterior clinoidectomyincreased the space of surgery. |
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