The endoscopic endonasal transoculomotor approach (EETA) has been recently described as a doorway to access the parapeduncular space and treat pituitary adenomas with oculomotor extension. Intraoperative identification of the oculomotor triangle endonasally is challenging and dissection can put the internal carotid artery (ICA) at risk. The aim of the present study is to find reliable landmarks that identify the oculomotor triangle (OCMT) during the EETA and protect the ICA from injury. Several lines were defined for calculations. Among them, one oblique line that extends from the inferior margin of the lateral orbital canal recess to the vidian canal was named the clinoid-to-vidian line (CVL), while a vertical line that extends over the most medial point of the paraclival ICA was titled the sagittal paraclival line (SPL). Anatomic relationships between the OCMT to these lines were assessed in 7 cadaveric heads. The intersecting point between the CVL and SPL is located within 2 mm of the center of the OCMT (mean 0.8 ± 0.5 mm), and 1.1 ± 0.8 mm medially and above the parasellar ICA. CVL and SPL are reliable landmarks during the EETA that can both protect the parasellar ICA and anatomically orientate to the blind spot that corresponds with the OCMT. We recommend starting dissection medial and superior to the CVL-SPL intersecting point, and carry the dissection laterally thereafter to avoid inadvertent injury of the ICA.

最近，内窥镜经鼻内经眼运动入路 (EETA) 被描述为进入脚旁空间和通过动眼神经伸展治疗垂体腺瘤的入口。术中通过鼻内识别动眼神经三角具有挑战性，解剖可能会使颈内动脉 (ICA) 处于危险之中。本研究的目的是找到可靠的标志物，在 EETA 期间识别动眼神经三角 (OCMT) 并保护 ICA 免受伤害。为计算定义了几行。其中，一条从眶外侧隐窝下缘延伸至翼管的斜线称为床突-翼管线（CVL），而一条垂直线延伸至斜坡旁ICA最内侧点被命名为矢状旁斜坡线（SPL）。OCMT 与这些线之间的解剖关系在 7 个尸体头部中进行了评估。CVL 和 SPL 之间的交点位于 OCMT 中心 2 mm 范围内（平均 0.8 ± 0.5 mm），以及鞍旁 ICA 内侧和上方 1.1 ± 0.8 mm。CVL 和 SPL 是 EETA 期间的可靠标志，既可以保护鞍旁 ICA，又可以在解剖学上定位到与 OCMT 对应的盲点。我们建议在 CVL-SPL 交叉点的内侧和上方开始解剖，然后从侧面进行解剖，以避免无意中损伤 ICA。CVL 和 SPL 是 EETA 期间的可靠标志，既可以保护鞍旁 ICA，又可以在解剖学上定位到与 OCMT 对应的盲点。我们建议在 CVL-SPL 交叉点的内侧和上方开始解剖，然后从侧面进行解剖，以避免无意中损伤 ICA。CVL 和 SPL 是 EETA 期间的可靠标志，既可以保护鞍旁 ICA，又可以在解剖学上定位到与 OCMT 对应的盲点。我们建议在 CVL-SPL 交叉点的内侧和上方开始解剖，然后从侧面进行解剖，以避免无意中损伤 ICA。