Pai S Balaji, Nagarjun M N
Department of Neurosurgery, Bangalore Medical College and Research Institute, Bangalore, Karnataka, India.
Neurol India. 2017 Sep-Oct;65(5):1094-1101. doi: 10.4103/neuroindia.NI_726_17.
Neurosurgeons are getting increasingly involved in surgery for orbital tumours. The various approaches to the orbit can be challenging. The authors have demonstrated on cadavers the various approaches to the orbit which are required to be mastered by the neurosurgeon. The superior approaches which include the transcranial, supraorbital and the hybrid approaches are the most commonly utilized surgical approaches by the neurosurgeon for excision of orbital pathologies. The lateral orbitotomy is an elegant approach for excision of the tumours lateral to the optic Nerve and lacrimal gland tumours. The authors also demonstrate the medial approach through a medial orbitotomy which is a relatively unfamiliar approach to neurosurgeons. The importance of the various landmarks in each approach is emphasised along with the methods to minimize complications. It is imperative that neurosurgeons are intimately familiar with the microsurgical anatomy of the orbit and the various approaches to it.
神经外科医生越来越多地参与眼眶肿瘤手术。眼眶的各种手术入路颇具挑战性。作者已在尸体上展示了神经外科医生需要掌握的眼眶各种手术入路。包括经颅、眶上及混合入路在内的上方入路是神经外科医生切除眼眶病变时最常用的手术入路。外侧眶切开术是切除视神经外侧肿瘤及泪腺肿瘤的一种精巧入路。作者还展示了通过内侧眶切开术的内侧入路，这对神经外科医生来说是一种相对不熟悉的入路。文中强调了每种入路中各个标志的重要性以及将并发症降至最低的方法。神经外科医生必须熟知眼眶的显微外科解剖结构及其各种手术入路。
