Clinical anatomical study for development of new approaches tothe skull base

1.颅底解剖研究采用10具尸体进行颅底新手术入路的解剖研究。通常，手术入路到颅底的下侧面需要大的面部皮肤切口。术后造成面部瘢痕和畸形，显著降低患者的生活质量。另一方面，当应用新开发的技术，例如面部揭膜法或be - Fort 1截骨入路时，可以在没有大的面部疤痕的情况下接近颅底的下侧面。然而，如果采用这些入路，可能会限制手术野的暴露程度。利用尸体解剖证实，新方法与常规方法接近的手术野范围相同。颅底三维重建；解剖三维；颅底的构造尚未完成。然而，CT图像引导导航系统在颅底模拟手术中的临床应用得到了发展。颅底手术中各种暴露组织的血管分布。为了暴露颅骨和面部的深层部分，需要去除面部的许多骨骼和软组织。切除病变后，这些组织得以恢复。为了稳定复位，保存组织的血管性是重要的。在颅底手术过程中，使用激光多普勒法检查这些组织的血流。稍后将对结果进行分析。

1.Anatomical study of the skull baseAnatomical study for development of new surgical approaches to the skull base was performed using 10 cadavers.Usually, surgical approach to the inferior aspect of the skull base needs large facial skin incision. It causes postoperative facial scar and deformity and remarkably deteriorates the QOL.On the other hand, when newly developed techniques, for example, Facial Dismasking method or be Fort 1 Osteotomy approach, are applied, the inferior aspect of the skull base can be approached without large facial scar. However there might be a limitation of the extent of the exposure of the surgical field if those approaches are applied. Using cadaver dissections, it was confirmed that extent of surgical field approached by new methods is the same as that approached by conventional method.2. Three-dimensional reconstruction of the skull baseAnatomical 3-D n; construction of the skull base is not completed yet. However, new clinical application of the CT image-guided navigation system was developed for simulation surgery of the skull base.3. Vascularity of the various exposed tissue in the skull base surgery.In order to expose the deep part of the skull and face, a lot of skeletons and soft tissues in the face need to be removed.After extirpation of the lesion, those tissues are restored. For stable reduction, preservation of the vascularity of the tissues is important. Using Laser Doppler method, blood flow of those tissues was examined during the skull base surgery. The result will be analyzed, later on.