Gardner Paul A, Prevedello Daniel M, Kassam Amin B, Snyderman Carl H, Carrau Ricardo L, Mintz Arlan H
Department of Neurosurgery, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.
J Neurosurg. 2008 May;108(5):1043-7. doi: 10.3171/JNS/2008/108/5/1043.
Craniopharyngiomas have always been an extremely challenging type of tumor to treat. The transsphenoidal route has been used for resection of these lesions since its introduction. The authors present a historical review of the literature from the introduction of the endonasal route for resection of craniopharyngiomas until the present. Abandoned early due to technological limitations, this approach has been expanded both in its application and in its anatomical boundaries with subsequent progressive improvements in outcomes. This expansion has coincided with advances in visualization devices, imaging guidance techniques, and anatomical understanding. The progression from the use of headlights, to microscopy, to endoscopy and fluoroscopy, and finally to modern intraoperative magnetic resonance-guided techniques, combined with collaboration between otolaryngologists and neurosurgeons, has provided the framework for the development of current techniques for the resection of sellar and suprasellar craniopharyngiomas.
颅咽管瘤一直是一种极难治疗的肿瘤类型。经蝶窦入路自引入以来就被用于切除这些病变。作者对从经鼻入路切除颅咽管瘤的引入到目前的文献进行了历史回顾。由于技术限制，这种方法早期被放弃，但随着后续结果的逐步改善，其应用范围和解剖边界都得到了扩展。这种扩展与可视化设备、影像引导技术以及解剖学认识的进步相契合。从使用头灯，到显微镜，再到内窥镜和荧光镜检查，最后到现代术中磁共振引导技术，加上耳鼻喉科医生和神经外科医生之间的合作，为目前蝶鞍区和鞍上区颅咽管瘤切除技术的发展提供了框架。
