Lysoń Tomasz, Sieśkiewicz Andrzej, Rutkowski Robert, Kochanowicz Jan, Turek Grzegorz, Rogowski Marek, Mariak Zenon
Klinika Neurochirurgii, Uniwersytet Medyczny w Białymstoku, Białystok.
Neurol Neurochir Pol. 2013 Jan-Feb;47(1):63-73. doi: 10.5114/ninp.2012.31474.
Recent advances in surgical endoscopy have made it possible to reach nearly the whole cranial base through a transnasal approach. These 'expanded approaches' lead to the frontal sinuses, the cribriform plate and planum sphenoidale, the suprasellar space, the clivus, odontoid and atlas. By pointing the endoscope laterally, the surgeon can explore structures in the coronal plane such as the cavernous sinuses, the pyramid and Meckel cave, the sphenopalatine and subtemporal fossae, and even the middle fossa and the orbit. The authors of this contribution use most of these approaches in their endoscopic skull base surgery. The purpose of this contribution is to review the hitherto established endoscopic approaches to the skull base and to illustrate them with photographs obtained during self-performed procedures and/or cadaver studies.
外科内镜技术的最新进展使得通过经鼻入路几乎能够到达整个颅底。这些“扩展入路”可通向额窦、筛板和蝶骨平台、鞍上间隙、斜坡、齿状突和第一颈椎。通过将内镜侧向定位,外科医生可以在冠状平面上探查诸如海绵窦、颞骨岩部和 Meckel 腔、蝶腭窝和颞下窝等结构,甚至还能探查中颅窝和眼眶。本文作者在其内镜颅底手术中使用了大部分这些入路。本文的目的是回顾迄今已确立的内镜颅底入路,并通过在自己实施的手术过程中和/或尸体研究中获得的照片对其进行说明。