Bedi Anupama D, Toms Steven A, Dehdashti Amir R
Skull Base. 2011 May;21(3):189-92. doi: 10.1055/s-0031-1275632.
The endoscopic endonasal approach offers a wide, panoramic exposure of the sellar floor, planum, and clivus. The ability to expose fully the tumor margins, through lateral extension of cavernous sinuses, increases the exposure and ability to resect the tumor but increases the risk of bleeding. The authors describe achieving hemostasis using a hemostatic matrix, FloSeal (Baxter Biosciences, Vienna, Austria) sealant, during endoscopic endonasal tumor removal, specifically for pituitary and suprasellar tumors. Thirty-nine cases (33 pituitary adenomas, 4 craniopharyngiomas, 1 clival plasmacytoma, and 1 planum meningioma) are described using this technique. FloSeal was injected directly to the site of bleeding, and a cottonoid was used for further tamponade, immediately achieving hemostasis with no hemorrhagic complications in any of the patients. Surgery could be immediately pursued without any delay. This simple nuance can be used as a safe method in cavernous sinus hemostasis during endoscopic endonasal surgery and may decrease operative time.
经鼻内镜入路可提供对鞍底、蝶鞍平面和斜坡的广泛全景暴露。通过向海绵窦外侧扩展来充分暴露肿瘤边缘，增加了暴露范围和肿瘤切除能力，但也增加了出血风险。作者描述了在经鼻内镜肿瘤切除术中，特别是针对垂体瘤和鞍上肿瘤，使用止血基质FloSeal（百特生物科学公司，奥地利维也纳）密封剂实现止血的方法。本文描述了使用该技术的39例病例（33例垂体腺瘤、4例颅咽管瘤、1例斜坡浆细胞瘤和1例蝶鞍平面脑膜瘤）。将FloSeal直接注射到出血部位，并用棉片进一步填塞，所有患者均立即实现止血，无出血并发症。手术可立即进行，无需任何延迟。这种简单的细微差别可作为经鼻内镜手术中海绵窦止血的一种安全方法，并可能缩短手术时间。
