Bhatki Amol M, Carrau Ricardo L, Snyderman Carl H, Prevedello Daniel M, Gardner Paul A, Kassam Amin B
Department of Otolaryngology - Head and Neck Surgery, University of Pittsburgh School of Medicine, 200 Lothrop Street, Suite 500, Pittsburgh, PA 15213, USA.
Oral Maxillofac Surg Clin North Am. 2010 Feb;22(1):157-68. doi: 10.1016/j.coms.2009.10.005.
Skull base surgery is evolving from traditional transfacial and transcranial approaches to the endoscopic endonasal approach, a less intrusive corridor for accessing the ventral skull base. This technique eliminates facial scars, expedites recovery, and obviates brain retraction. The goals of surgical excision, whether palliative or curative, are identical: an approach that is less disruptive to normal tissues. By exploiting the sinonasal corridor, the entire ventral skull base may be accessed to successfully treat benign and malignant lesions. The expanding limits of endoscopic skull base surgery have been accompanied by commensurate innovations in reconstructive techniques that are reliable and have been shown to limit postoperative complications. This article describes the basis for this approach and provides the latest outcome data supporting the current state of the art for endoscopic skull base surgery.
颅底手术正从传统的经面部和经颅入路发展到鼻内镜下经鼻入路，这是一种侵入性较小的进入腹侧颅底的通道。该技术消除了面部瘢痕，加快了恢复，并避免了脑牵拉。手术切除的目标，无论是姑息性还是根治性的，都是相同的：一种对正常组织干扰较小的入路。通过利用鼻窦通道，可以进入整个腹侧颅底，成功治疗良性和恶性病变。内镜颅底手术范围的扩大伴随着重建技术的相应创新，这些技术可靠且已被证明可减少术后并发症。本文描述了这种入路的基础，并提供了支持内镜颅底手术当前技术水平的最新结果数据。
