放射科医生的扩大经鼻内镜颅底手术入路

Expanded Endonasal Endoscopic Approaches to the Skull Base for the Radiologist.

作者信息

Roxbury Christopher R, Ishii Masaru, Blitz Ari Meir, Reh Douglas D, Gallia Gary L

机构信息

Department of Otolaryngology - Head and Neck Surgery, Johns Hopkins Hospital, 601 North Caroline Street, Baltimore, MD 21287, USA.

Division of Neuroradiology, Department of Radiology and Radiological Science, Johns Hopkins Hospital, 600 North Wolfe Street, Baltimore, MD 21287, USA.

出版信息

Radiol Clin North Am. 2017 Jan;55(1):1-16. doi: 10.1016/j.rcl.2016.09.001.

DOI:10.1016/j.rcl.2016.09.001

PMID:27890179

Abstract

The cranial base is a complex 3-D region that contains critical neurovascular structures. Pathologies affecting this region represent some of the most challenging lesions to manage due to difficulty with access and risk of significant postoperative morbidity. With the development of expanded endonasal endoscopic approaches, skull base surgeons use the nose and paranasal sinuses as a corridor to access selected ventral skull base lesions. This review discusses high-resolution imaging in the evaluation of patients with skull base lesions considered for endonasal endoscopic surgery, summarizes various expanded endonasal endoscopic approaches, and provides examples of commonly used expanded endonasal endoscopic procedures.

摘要

颅底是一个复杂的三维区域，包含关键的神经血管结构。由于手术入路困难以及术后严重并发症的风险，影响该区域的病变是最难处理的一些病变。随着扩大经鼻内镜入路的发展，颅底外科医生利用鼻腔和鼻窦作为通道来处理特定的腹侧颅底病变。本文综述了用于评估考虑行经鼻内镜手术的颅底病变患者的高分辨率成像，总结了各种扩大经鼻内镜入路，并提供了常用的扩大经鼻内镜手术的实例。