Rosen Marc R, Rabinowitz Mindy R, Farrell Christopher J, Schaberg Madeleine R, Evans James J
Departments of Otolaryngology-Head and Neck Surgery, Thomas Jefferson University, Philadelphia, Pennsylvania.
Neurosurg Focus. 2014;37(4):E6. doi: 10.3171/2014.7.FOCUS14308.
Endonasal resection of olfactory groove meningiomas allows for several advantages over transcranial routes, including a direct approach to the bilateral anterior cranial base and dura mater, early tumor devascularization, and avoidance of brain retraction. Although considered minimally invasive, the endoscopic approach to the cribriform plate typically requires resection of the superior nasal septum, resulting in a large superior septal perforation. The septal transposition technique improves preservation of sinonasal anatomy through the elimination of a septal perforation while allowing for wide exposure to the midline anterior cranial base and harvest of a nasal septal flap. Herein, the authors describe a 39-year-old female who presented with a progressively enlarging olfactory groove meningioma. An endoscopic endonasal resection with a septal transposition technique was performed. On follow-up, the nasal cavity had completely normal anatomy with preservation of the turbinates and nasal septum. The authors conclude that septal transposition is a useful technique that allows wide exposure of the anterior cranial base with maximal preservation of normal nasal anatomy and avoidance of a large septal perforation.
经鼻切除嗅沟脑膜瘤相对于经颅途径具有多个优势，包括可直接到达双侧前颅底和硬脑膜、早期肿瘤去血管化以及避免脑牵拉。尽管内镜入路被认为是微创的，但经鼻内镜处理筛板通常需要切除鼻中隔上部，导致较大的鼻中隔上穿孔。鼻中隔转位技术通过消除鼻中隔穿孔改善了鼻窦解剖结构的保留，同时允许广泛暴露中线前颅底并获取鼻中隔瓣。在此，作者描述了一名39岁女性，她患有逐渐增大的嗅沟脑膜瘤。采用鼻中隔转位技术进行了内镜下经鼻切除术。随访时，鼻腔解剖结构完全正常，鼻甲和鼻中隔得以保留。作者得出结论，鼻中隔转位是一种有用的技术，可广泛暴露前颅底，最大程度保留正常鼻腔解剖结构并避免较大的鼻中隔穿孔。
