Reisch Robert, Briner Hans Rudolf, Hickmann Anne-Katrin
ENDOMIN - Center for Endoscopic and Minimally Invasive Neurosurgery, Hirslanden Hospital, Zurich, Switzerland.
Center for Otorhinolaryngology, Head and Neck Surgery, Hirslanden Hospital, Zurich, Switzerland.
Acta Neurochir (Wien). 2017 Mar;159(3):453-457. doi: 10.1007/s00701-017-3075-6. Epub 2017 Jan 18.
The use of endoscopes in transnasal surgery offers increased visualization. To minimize rhinological morbidity without restriction in manipulation, we introduced the mononostril transethmoidal-paraseptal approach.
The aim of the transethmoidal-paraseptal approach is to create sufficient space within the nasal cavity, without removal of nasal turbinates and septum. Therefore, as a first step, a partial ethmoidectomy is performed. The middle and superior turbinates are then lateralized into the ethmoidal space, allowing a wide sphenoidotomy with exposure of the central skull base.
This minimally invasive transethmoidal-paraseptal approach is a feasible alternative to traumatic transnasal concepts with middle turbinate and extended septal resection.
在内镜经鼻手术中使用内镜可提高可视化程度。为了在不限制操作的情况下将鼻科发病率降至最低，我们引入了单鼻孔经筛窦 - 鼻中隔旁入路。
经筛窦 - 鼻中隔旁入路的目的是在不切除鼻甲和鼻中隔的情况下，在鼻腔内创造足够的空间。因此，第一步是进行部分筛窦切除术。然后将中鼻甲和上鼻甲向外侧移入筛窦间隙，以便进行广泛的蝶窦切开术并暴露中央颅底。
这种微创经筛窦 - 鼻中隔旁入路是一种可行的替代方案，可替代需要切除中鼻甲和扩大鼻中隔切除术的创伤性经鼻手术概念。
