MBaye M, Jouanneau E, Mottolese C, Simon E
Département de neurochirurgie B, hôpital neurologique Pierre Wertheimer, groupement hospitalier Est, hospices civils de Lyon, 69677 Bron cedex, France.
Faculté de médecine Lyon-Sud, université Lyon I, 69921 Oullins cedex, France; Équipe ONCOFLAM, Inserm U 1028, CNRS UMR 5292, 69372 Lyon cedex, France; Département de neurochirurgie A, hôpital neurologique Pierre Wertheimer, groupement hospitalier Est, hospices civils de Lyon, 69677 Bron cedex, France.
Neurochirurgie. 2015 Apr-Jun;61(2-3):184-92. doi: 10.1016/j.neuchi.2013.04.002. Epub 2014 Mar 12.
Deeply located beneath the corpus callosum and surrounding by crucial veins, the pineal and tectal structures still challenge the surgeon. Either anterior or posterior, many surgical approaches have been developed to reach the pineal region. Most popular are likely the posterior sub-occipital or occipito-parietal transtentorial routes. Others, primarily transcallosal or supracerebellar, may be indicated depending of the extension of the tumors while the transcortical routes (frontal, parietal or atrial) have been almost given up. Our purpose in this article is give a practical overview of how to do and what are the respective indications of all these alternatives approaches developed for pineal tumors.
松果体和顶盖结构位于胼胝体下方深处，周围环绕着重要血管，这仍然给外科医生带来挑战。无论是前路还是后路，已经开发了许多手术入路来抵达松果体区。最常用的可能是后枕下或枕顶经小脑幕入路。其他入路，主要是经胼胝体或小脑上入路，可能根据肿瘤的范围而选择，而经皮质入路（额叶、顶叶或颞叶）几乎已被放弃。本文的目的是对针对松果体肿瘤开发的所有这些替代入路的操作方法及其各自的适应症进行实际概述。
