Hwang Peter Y, Ho Chi Long
Department of Neurosurgery, The Alfred Hospital, Monash University, Victoria, Australia.
Neurosurgery. 2007 Nov;61(5 Suppl 2):212-7; discussion 217-8. doi: 10.1227/01.neu.0000303219.55393.fe.
Surgical approaches described for resection of clival tumors have been complicated, extensive, traumatic, and invasive. They are also associated with significant mortality and morbidity rates. We describe a minimally invasive, endoscopic transsphenoidal surgical treatment for clival tumors.
Three men, aged 43, 46, and 66 years, each presented with a history of headaches, diplopia, and multiple cranial nerve deficits. All preoperative magnetic resonance imaging scans showed large clival tumors. A neuronavigational image-guided endoscopic transnasal-sphenoethmoidal approach was performed to resect the clival tumors.
All three patients had near-total removal of clival tumors using this method, and the histology revealed chordomas. They underwent postoperative adjuvant radiotherapy. No complications were encountered. All patients were able to resume their usual activities on the same day after surgery. Furthermore, this technique greatly reduced patient discomfort, hastened recovery, and shortened the hospital stay.
The neuronavigation image-guided transsphenoidal approach is a viable, minimally invasive alternative for surgical treatment of clival tumors.
已描述的用于切除斜坡肿瘤的手术方法复杂、范围广、创伤大且具有侵入性。它们还与显著的死亡率和发病率相关。我们描述一种用于斜坡肿瘤的微创、内镜经蝶窦手术治疗方法。
三名男性，年龄分别为43岁、46岁和66岁，均有头痛、复视和多条颅神经功能缺损病史。所有术前磁共振成像扫描均显示巨大斜坡肿瘤。采用神经导航图像引导的内镜经鼻-蝶筛窦入路切除斜坡肿瘤。
所有三名患者使用该方法均实现了斜坡肿瘤的近全切除，组织学检查显示为脊索瘤。他们接受了术后辅助放疗。未出现并发症。所有患者术后当天即可恢复日常活动。此外，该技术极大地减轻了患者不适，加速了康复，并缩短了住院时间。
神经导航图像引导经蝶窦入路是一种可行的、微创的斜坡肿瘤手术治疗替代方法。
