Paluzzi Alessandro, Gardner Paul, Fernandez-Miranda Juan Carlos, Snyderman Carl
Center for Skull Base Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA 15213, USA.
Br J Neurosurg. 2012 Oct;26(5):649-61. doi: 10.3109/02688697.2012.673649. Epub 2012 Apr 3.
The endoscopic endonasal approach (EEA) is a surgical technique where a small aperture, the nostrils, can give access to the whole ventral skull base. Its principles differ from the ones of traditional skull base approaches where a wide external opening is often accompanied by a relatively small working area. Most of the results of EEAs published in the literature come from retrospective case series and the follow-up is still limited, however the consensus is that this technique is safe and effective in selected cases and when performed within dedicated skull base centres. This article sets to give an overview of the current state of endoscopic skull base surgery, based on the recent evidence and our centre's experience with nearly 2000 EEAs. The team's experience with endoscopic as well as open approaches plays a critical role in achieving satisfactory results when treating pathologies of the skull base. Guided by the principle of least neural and vascular manipulation, the team should be able to select the least traumatic route (open or endoscopic) and be able to approach the skull base from all angles.
鼻内镜鼻内入路（EEA）是一种外科技术，通过一个小孔径（鼻孔）可进入整个腹侧颅底。其原理与传统颅底入路不同，传统颅底入路通常有一个较大的外部开口，但工作区域相对较小。文献中发表的大多数鼻内镜鼻内入路的结果来自回顾性病例系列，随访仍然有限，然而，共识是该技术在特定病例中以及在专门的颅底中心进行时是安全有效的。本文基于最新证据和我们中心近2000例鼻内镜鼻内入路的经验，对鼻内镜颅底手术的现状进行概述。在治疗颅底病变时，团队在内镜及开放入路方面的经验对取得满意结果起着关键作用。遵循最小化神经和血管操作的原则，团队应能够选择创伤最小的途径（开放或内镜），并能够从各个角度接近颅底。
