鼻内镜鼻窦和颅底手术中动脉损伤的处理
Management of arterial injury during endoscopic sinus and skull base surgery.
作者信息
Valentine Rowan, Padhye Vikram, Wormald Peter-John
机构信息
aDepartment of Surgery - Otorhinolaryngology, Head and Neck Surgery, University of Adelaide, Adelaide bDepartment of Surgery - Otorhinolaryngology, Head and Neck Surgery, The Queen Elizabeth Hospital, Woodville, Australia.
出版信息
Curr Opin Otolaryngol Head Neck Surg. 2016 Apr;24(2):170-4. doi: 10.1097/MOO.0000000000000239.
PURPOSE OF REVIEW
The most feared complication during endonasal surgery is a carotid artery injury. The sheep model of carotid injury provides training for this event by giving a realistic endoscopic experience of major vascular injuries and tissue hemostasis.
RECENT FINDINGS
The sheep model of carotid artery injury recreates the narrow nasal confines and high-flow/high-pressure vascular injury accurately reproducing the endoscopic challenges seen in such vascular emergencies. This has led to the development of surgical techniques that quickly and effectively control the field of bleeding and achieve reliable hemostasis including the crushed muscle patch new direct vascular closure technologies. Vascular emergency simulation training is achieving better outcomes for our patients.
SUMMARY
All skull base surgeons are at risk of the unexpected carotid artery injury and recently, the sheep model not only effectively recreates this situation but has identified clinically tried and tested techniques at managing this situation and is improving patient outcomes.
综述目的
鼻内手术期间最令人担忧的并发症是颈动脉损伤。颈动脉损伤的绵羊模型通过提供主要血管损伤和组织止血的逼真内镜体验，为应对这一情况提供了训练。
最新发现
颈动脉损伤的绵羊模型再现了狭窄的鼻腔环境以及高流量/高压血管损伤，准确地重现了此类血管紧急情况中所见的内镜挑战。这促使了手术技术的发展，这些技术能够快速有效地控制出血区域并实现可靠的止血，包括挤压肌肉贴片和新的直接血管闭合技术。血管紧急情况模拟训练正在为我们的患者带来更好的治疗效果。
总结
所有颅底外科医生都面临意外颈动脉损伤的风险，最近，绵羊模型不仅有效地再现了这种情况，还确定了临床上经过试验和测试的应对这种情况的技术，并且正在改善患者的治疗效果。
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