Endoscopic Anatomical Study of the Glabellar Keyhole Approach

To observe the exposure range of a neuroendoscope through the glabellar approach and measure the anatomical parameters to provide a basis for clinical application.

A total of 10 adult cadaveric heads fixed with formalin were dissected by stratified local anatomy and simulated operation. The length of each point was measured from the corresponding anatomical mark of the anterior fossa on the bone window plate and analysed to clarify relevant surgical indications and feasibility to provide an anatomical basis for clinical application.

The distance from the lower boundary of the bone window to the left anterior clinoid process was (61.97 ± 3.51) mm, the distance to the right anterior clinoid process was (62.21 ± 3.20) mm, the distance to the leading edge of the optic chiasma was (67.40 ± 5.38) mm, the distance to the sellar tubercle was (57.91 ± 2.64) mm, the distance to the centre of the saddle septum was (68.45 ± 4.88) mm; the distance to the midpoint of the endplate was (67.86 ± 4.91) mm, the distance to the anterior communicating artery was (60.89 ± 6.17) mm, the distance to the left posterior clinoid process was (67.56 ± 3.84) mm, the distance to the right posterior clinoid process was (66.78 ± 3.23) mm, the distance to the bifurcation of the left internal carotid artery was (69.45 ± 2.34) mm and the distance to the bifurcation of the right internal carotid artery was (68.01 ± 3.53) mm.

The neuroendoscopic glabellar approach can effectively expose the anatomical structures of the midline anterior skull base and both sides near the sellar area and can be used to look for lesions in the midline anterior skull base.