Study On Microanatomy Of The Sellar Tumour

Sellar region is located in the central of the skull base. It contains thepituitary, the internal carotid artery, optic nerve, optic chiasm, cavernous sinus,Wills artery ring, Ⅱ-Ⅵ cranial nerves and so on. Simultaneously, sellartumor is offen discovered in this region. My study is intended to provide thebasis for further clinical surgery and surgical approach by the anatomy of thesellar region.Object：Using adult cadaveric head as the object of the study, exploring sellartumors and its adjacent structure of the local anatomy,in order to provide someanatomic data and surgical considerations for surgery and the surgicalapproach of sellar tumors, such as pituitary microadenoma,craniopharyngioma, meningiomamicrosurgical treatment and so on, help usacquaintance with the structure of the sellar region and its adjacent anatomicrelationship; reduce and avoid the occurrence of postoperative complications.Methods：Using adult wet cadaver15cases (30sides) which have fixed in10%formalin and perfusioned with color silicone to observe sellar anterior clinoidposterior clinoid, pituitary, optic chiasm, ophthalmic artery structure and itsadjacent;To observe cavernous sinus and its contents oculomotor, such astrochlear nerve, trigeminal nerve, abducens nerve and the internal carotidartery in the cavernous sinus walk the line and its anatomical relationship. Toobserve the sphenoid important structure and its adjacent structure relationship.To observe the structures and characteristics exposured in the commonapproach of the Sellar tumour.. The important structural was measured andrecorded during the study. At the same time, imaging data were held in thecourse of the study. The data were statistically analyzed using SPSS17.0.Results：Sella region contents the sellar and its surrounding structure, which is located in the middle cranial fossa.The sella is located in the middle of thesphenoid bone, the former sector is the tuberculum sellae and after sector issaddleback.In my study, the saddleback height of the left is (10.72±1.42) mm,the right is (10.78±1.42)mm, the length of the sella is (16.85±2.00) mm;maximum diameter of the sella is (12.36±2.64) mm. The pituitary fossa isrecessed to accommodate the pituitary. In the data, which is measured in thisgroup, the anteroposterior diameter is (11.63±1.06) mm, the diameter ofabout is (12.37±0.87) mm, the vertical diameter is (8.06±1.19) mm. Theanterior clinoid are protrusions located on two sides of the sella.The distanceof the two anterior clinoid process is (24.78±1.90) mm. Posterior clinoidprocess are protrusions located on two sides of the saddleback.The distance ofthe two posterior clinoid process is (15.05±2.04) mm.. The internal carotidartery sulcus besides the sphenoid bone,and the carotid cavernous segment ismove forward in this sulcus. The cavernous sinus besides the sella. Its innerwall is a single-layer dura mater while the outer wall is double duramater.Between the double duramater is the oculomotor nerve, trochlear nerve andthe trigeminal eye branch,walking from the upper to lower.Abducens nerve,internal carotid artery and its branches, sella sinus venous plexus which alsonamed sympathetic nerve fibers are working between the inner walland the theouter wall. Above sella is the optic nerve and chiasm, the distance between thetwo optic nerve, in the the optic canal intracranial mouth is (13.13±1.52)mm. Below the sella is sphenoid sinus. It is very essential to find the sphenoidsinus openings,which is usually roundness or oval.The two hatches aresituated in the antetheca of cavernous sinus,like the shaoe of “八”. The leftsphenoid sinus openings longitudinal diameter is (3.47±0.22) mm, transversediameter is (1.60±0.22) mm, the right sphenoid openings longitudinaldiameter is (3.34±0.21) mm, transverse diameter (1.50±0.21)mm. Thedifference betweenthe height of the two sphenoid sinus openings is (2.45±1.35) mm..Conclusion：1、Sellar region is located in the central of the skull base,while the pituitary is the center of it. It contains (or besides) important structures,suchas the third ventricle, optic chiasm, optic nerve, the internal carotid artery andthe cavernous sinus, Wills artery ring, Ⅱ-Ⅵ cranialnerves and so on.2、The pituitary is divided into adenohypophysis (anterior lobe) andneurohypophysis (posterior lobe).Above it is the optic chiasm, the part of thecircle of Willis artery ring and the third ventricle.Below it is the sphenoid bone,lateral to the cavernous sinus and internal carotid artery.Behind it is thebrainstemand basilar arteries. Approaching the enter in the most commonoperation of pituitary lesions is from the front or below.3、Cavernous sinus cavities is the lacuna between the two sides of thedura mater. It is located in the middle cranial fossa (besides the sella), dividedinto inner and outer walls. Its inner wall is a single-layer dura mater while theouter wall is double duramater. Between the double duramater is oculomotor(III), trochlear nerve (IV), the trigeminal nerve ophthalmic (Ⅴ1),walkingfrom the upper to lower. the exhibition nerve (VI), the structure of the internalcarotid artery (ICA) and so on are working between the inner wall and the theouters.4、Sphenoid is located in the central of the skull base. Above it is thepituitary, and belowe is the nasal cavity. Sphenoid sinus is the cavity in in theSphenoid, It is the only way to operation resection of sellar tumors throughthe nasal cavity. The bone thickness of it is very immportent for this lind ofsurgery.5、There are several Common operation approach of Sellar tumors,through the nose approach, through the frontal approach, pterional keyholeapproach and the nasal approach, and through the nose approach is the mostcommon. Different surgical approach have different characteristices and adaptto different situation.We should be selected surgical approach according to thenature of disease in clinical...