Düz B, Secer H I, Tosun F, Gonul E
Department of Neurosurgery, Gulhane Military Medical Academy (GATA), Ankara, Turkey.
Minim Invasive Neurosurg. 2007 Dec;50(6):363-6. doi: 10.1055/s-2007-993161.
Dermoid and epidermoid cysts are congenital, slowly growing tumours that usually become symptomatic when patients reach the middle of their third decade. An otherwise healthy 20-year-old man presented with an epileptic attack. Imaging studies including computed tomography and magnetic resonance imaging revealed an intradural cystic lesion located in the anterior subfrontal region. Choices of traditional approaches for such a lesion are a bicoronal craniotomy or a transfacial procedure. Taking the advantage of the endoscope, the authors decided to remove the lesion via an endonasal route. After a fully endoscopic endonasal operation, gross total resection of the dermoid tumour was achieved. We have not observed cerebrospinal fluid leakage or any infectious complication after the operation. In this report the technique of operation and reconstruction method are described. The endoscopic endonasal approach offers a good option for lesions located in the anterior skull base. Carefully piecemeal resection of the tumour while preserving the underlying neural and vascular structures should be the main strategy of the operation. Reconstruction is very important after the surgery and a carefully planned pedicled graft technique may help in the prevention of cerebrospinal fluid leakage.
皮样囊肿和表皮样囊肿是先天性的、生长缓慢的肿瘤，通常在患者30岁左右时出现症状。一名20岁的健康男性出现癫痫发作。包括计算机断层扫描和磁共振成像在内的影像学检查显示，硬膜内囊性病变位于额下前区。对于这种病变，传统的手术方法包括双冠状开颅术或经面部手术。作者利用内镜的优势，决定通过鼻内途径切除病变。经过全内镜鼻内手术后，实现了皮样肿瘤的大体全切。术后我们未观察到脑脊液漏或任何感染性并发症。本报告描述了手术技术和重建方法。内镜鼻内入路为位于前颅底的病变提供了一个很好的选择。在保留其下方神经和血管结构的同时仔细地将肿瘤分块切除应是手术的主要策略。术后重建非常重要，精心规划的带蒂移植技术可能有助于预防脑脊液漏。
