Czirják S, Szeifert G T
National Institute of Neurosurgery, Budapest, Hungary.
Neurosurgery. 2001 Jan;48(1):145-9; discussion 149-50.
The purpose of this study was to evaluate the results of 173 frontolateral keyhole minicraniotomies performed on 155 patients with aneurysms of the anterior or posterior cerebral circulation and for supratentorial tumors.
The frontolateral keyhole craniotomy is a modification of the generally used pterional approach. Of the 155 patients studied, 102 harbored saccular arterial aneurysms in the vessels of the anterior or posterior cerebral circulation, and 53 had various tumors in the frontal base, suprasellar, or parasellar region. The operations were carried out through an approximately 2.5- x 3-cm frontolateral miniaturized craniotomy after a skin incision just above the eyebrow.
Despite the small size of the craniotomy, the exploration allows enough room for intracranial manipulation with maximal protection of the brain and other intracranial structures. The presented series of patients did not have any craniotomy-related complications.
In our experience, the frontolateral keyhole craniotomy, together with the advent of the modern neuroanesthesia, cerebrospinal fluid drainage, and microsurgical techniques, is a safe approach for an experienced neurosurgeon to use in the treatment of supratentorial aneurysms or tumors of the anterior fossa and sellar regions.
本研究旨在评估对155例大脑前循环或后循环动脉瘤患者以及幕上肿瘤患者实施的173例额颞部锁孔微创开颅手术的结果。
额颞部锁孔开颅术是对常用翼点入路的一种改良。在研究的155例患者中，102例患有大脑前循环或后循环血管的囊状动脉瘤，53例在额底、鞍上或鞍旁区域患有各种肿瘤。在眉上做皮肤切口后，通过一个约2.5×3厘米的额颞部小型化开颅术进行手术。
尽管开颅切口小，但该术式能提供足够的颅内操作空间，同时最大程度地保护脑和其他颅内结构。本系列患者未出现任何与开颅手术相关的并发症。
根据我们的经验，额颞部锁孔开颅术，结合现代神经麻醉、脑脊液引流和显微外科技术的出现，对于有经验的神经外科医生来说，是治疗幕上动脉瘤或前颅窝及鞍区肿瘤的一种安全方法。
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