Grevers G
Department of Otorhinolaryngology, Head and Neck Surgery, University of Munich, Munich, Germany.
Rhinology. 2001 Mar;39(1):1-4.
To determine typical locations for traumatic lesions of the anterior skull base during endoscopic sinus surgery.
In this retrospective study 12 patients were included who had undergone endoscopic sinus surgery for nasal polyposis and were referred to the author for revision surgery after iatrogenic trauma of the anterior skull base during the procedure. Each patient had been operated by a different surgeon, all of the physicians being in an advanced stage of their surgical career and being board certified otolaryngologists.
During endoscopically controlled revision surgery, all lesions could be detected, 10 of them being located in the ethmoid roof, while one injury had occurred in the lateral lamella of the cribriform plate and another one in the olfactory groove between the medial turbinate and the nasal septum.
In contrast to reports in the literature, the preferred site for anterior skull base injuries during endoscopic sinus surgery in our group was not the lateral lamella of the cribriform plate, but the anterior part of the ethmoid roof, just behind the frontal recess. Apparently the course of the ethmoid roof might be misinterpreted during sinus surgery even by surgeons who are familiar with the operative technique.
确定鼻内镜鼻窦手术中前颅底创伤性病变的典型位置。
在这项回顾性研究中，纳入了12例因鼻息肉接受鼻内镜鼻窦手术的患者，这些患者在手术过程中发生前颅底医源性创伤后被转介给作者进行翻修手术。每位患者均由不同的外科医生进行手术，所有医生均处于其外科职业生涯的高级阶段且均为获得委员会认证的耳鼻喉科医生。
在内镜控制下的翻修手术中，所有病变均能被检测到，其中10处位于筛窦顶部，1处发生在筛板外侧薄板，另1处位于中鼻甲与鼻中隔之间的嗅沟。
与文献报道相反，在我们的研究组中，鼻内镜鼻窦手术期间前颅底损伤的首选部位不是筛板外侧薄板，而是额隐窝后方的筛窦顶部前部。显然，即使是熟悉手术技术的外科医生，在鼻窦手术过程中也可能会误解筛窦顶部的走行。
