Prevedello Daniel M, Doglietto Francesco, Jane John A, Jagannathan Jay, Han Joseph, Laws Edward R
Department of Neurological Surgery, University of Virginia Health Sciences Center, Charlottesville, Virginia, USA.
J Neurosurg. 2007 Jul;107(1):206-13. doi: 10.3171/JNS-07/07/0206.
The history of the endoscope exemplifies the manner in which technological advances influence medicine and surgery. Endoscopic systems have evolved and improved, and they currently provide detailed visualization of a variety of deep organ structures. Otorhinolaryngological surgeons have used the endoscope for more than 30 years. In the 1990s, a number of influential neurosurgeons and otorhinolaryngological surgeons began performing purely endoscopic pituitary surgery. Endoscopic transsphenoidal operations are now extending beyond the sella. The collaboration between otorhinolaryngologists and neurosurgeons has produced a new subspecialty of "endoscopic skull base surgery." There is a great deal of progress still to be made in developing skills, instruments, and improving skull base repair. The extended skull base approaches allow surgical exposures from the olfactory groove to C-2 and to the infratemporal region and jugular fossa laterally. This article discusses the history of the endoscope, the pivotal technological advances, and the key figures in the burgeoning field of endoneurosurgery.
内窥镜的历史例证了技术进步影响医学和外科手术的方式。内窥镜系统不断发展和改进，目前能够提供各种深部器官结构的详细可视化图像。耳鼻咽喉科外科医生使用内窥镜已有30多年。在20世纪90年代，一些有影响力的神经外科医生和耳鼻咽喉科外科医生开始开展纯内窥镜垂体手术。目前，内窥镜经蝶窦手术已超出蝶鞍范围。耳鼻咽喉科医生与神经外科医生的合作催生了“内窥镜颅底外科”这一新的亚专业。在技能培养、器械研发以及改进颅底修复方面仍有很大的进步空间。扩大的颅底入路可实现从嗅沟至C-2以及外侧颞下区域和颈静脉窝的手术显露。本文将探讨内窥镜的历史、关键技术进展以及新兴的神经内镜手术领域的关键人物。
