Belli Evaristo, Longo Benedetto, Marini Filippo Balestra, Matteini Claudio
Maxillo-Facial Surgery Department, II Faculty of La Sapienza University at S. Andrea Hospital, Rome, Italy.
J Craniofac Surg. 2005 Jan;16(1):155-8. doi: 10.1097/00001665-200501000-00031.
Craniofacial malformations and upper third facial tumor surgical management is currently performed by skull base osteotomies to allow skeleton mobilization or tumor removal. Craniotomies and retraction of frontal lobes allow wide exposure of anterior skull base. In the last decades, in keeping with the trend to perform less invasive surgical approaches, several authors reported endoscopic approaches for selected cases of skull base surgery, such as closure of cerebrospinal fluid leaks and transethmoidal and trans-sphenoidal approaches for pituitary surgery. Recent experience with transnasal endoscopic procedures improved both techniques and outcomes and became more common. The authors present a cadaver study of combined transfacial transcranial endoscopic approach to skull base. Such an approach used with minimally invasive surgery principles could represent, in selected cases (both for neoplastic lesions and malformations), an alternative to traditional anterior cranial fossa surgical approaches by wide craniotomies.
颅面畸形和面部上三分之一肿瘤的外科治疗目前通过颅底截骨术来进行，以实现骨骼移动或肿瘤切除。开颅手术和额叶牵拉可广泛暴露前颅底。在过去几十年中，顺应实施侵入性较小的手术方法这一趋势，一些作者报道了针对特定颅底手术病例的内镜手术方法，如脑脊液漏修补以及垂体手术的经筛窦和经蝶窦手术方法。近期经鼻内镜手术的经验改善了技术和治疗效果，且变得更为常见。作者介绍了一项关于经面部经颅联合内镜入路颅底的尸体研究。在特定病例（包括肿瘤性病变和畸形）中，这种结合微创手术原则使用的入路可能成为传统广泛开颅前颅窝手术方法的一种替代方案。
