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鼻内镜下经鼻眶切开术治疗眼眶病变的适应证与局限性

Indications and limitations of endoscopic endonasal orbitotomy for orbital lesion.

作者信息

Karaki Masayuki, Akiyama Kosuke, Kagawa Masahiro, Tamiya Takashi, Mori Nozomu

机构信息

Department of Otorhinolaryngology Head and Neck Surgery, Faculty of Medicine, Kagawa University, Kagawa, Japan.

出版信息

J Craniofac Surg. 2012 Jul;23(4):1093-6. doi: 10.1097/SCS.0b013e31824f6680.

Abstract

BACKGROUND

Endoscopic endonasal surgical techniques have developed tremendously in the last 20 years. Endoscopic techniques have been applied to the treatment of cranial base lesions, pituitary tumors, orbital lesions, pterygopalatine fossa lesions, infratemporal fossa lesions, posterior cranial fossa lesions, and clival lesions. In some reports, endoscopic endonasal transparanasal orbitotomies have been indicated for lesions localized to the medial and inferomedial parts of the orbit. The aim of this article was to present the technique of endoscopic endonasal orbitotomy (EEO) for orbital extraperiosteal and intraperiosteal lesions, as well as its indications and limitations.

METHODS

We present cases of 4 patients who underwent EEO for typical extraperiosteal and intraperiosteal orbital lesions. We examined the indications and limitations in each case.

RESULTS

All 4 orbital lesions were completely removed by EEO with no major complications.

CONCLUSIONS

The EEO procedure, which does not require a skin incision, is a minimally invasive surgery used for treating orbital retrobulbar lesions. It leads to excellent cosmetic results with little bleeding. In the future, we need to determine its operative indications, safety, and dangers. It is necessary for us to further improve this surgical technique to allow for the generalization of the procedure.

摘要

背景

在过去20年里,鼻内镜手术技术取得了巨大发展。内镜技术已应用于颅底病变、垂体瘤、眼眶病变、翼腭窝病变、颞下窝病变、后颅窝病变及斜坡病变的治疗。在一些报道中,鼻内镜经鼻眶切开术已被用于治疗局限于眼眶内侧和内下部分的病变。本文旨在介绍鼻内镜经鼻眶切开术(EEO)治疗眼眶骨膜外和骨膜内病变的技术及其适应证和局限性。

方法

我们介绍了4例因典型的骨膜外和骨膜内眼眶病变接受EEO治疗的患者病例。我们检查了每个病例的适应证和局限性。

结果

所有4例眼眶病变均通过EEO完全切除,无重大并发症。

结论

EEO手术无需皮肤切口,是一种用于治疗眼眶球后病变的微创手术。它具有出色的美容效果,出血少。未来,我们需要确定其手术适应证、安全性和风险。我们有必要进一步改进这种手术技术,以便该手术能够得到推广。

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