Fomichev D V, Kalinin P L, Kutin M A, Sharipov O I, Chernov I V
Burdenko Neurosurgical Institute, Moscow, Russia.
Zh Vopr Neirokhir Im N N Burdenko. 2017;81(4):70-77. doi: 10.17116/neiro201781470-76.
Surgical treatment for epidermoid cysts of the chiasmatic region is a challenge because of the tendency to a massive spread of epidermoid masses through the cerebrospinal fluid pathways and a significant lesion deviation from the midline.
To analyze capabilities of the extended endoscopic endonasal transsphenoidal approach in surgery for epidermoid cysts.
The study included 6 patients with epidermoid cysts of the chiasmatic region who were operated on using the extended anterior endoscopic endonasal transsphenoidal approach at the Burdenko Neurosurgical Institute in the past 5 years.
Epidermoid masses were completely removed in 5 patients; in none of the cases, complete removal of the epidermoid cyst capsule was achieved. There were no cases of vision deterioration and the development of new focal neurological symptoms. One female patient developed hypopituitary disorders in the postoperative period. There was no recurrence of epidermoid cysts during follow-up.
Removal of epidermoid cysts of the chiasmatic region using the extended anterior endoscopic transsphenoidal approach may be an alternative to transcranial microsurgery.
由于表皮样囊肿有通过脑脊液通路广泛播散的倾向,且病变明显偏离中线,因此视交叉区域表皮样囊肿的手术治疗颇具挑战性。
分析扩大经鼻内镜经蝶窦入路在表皮样囊肿手术中的应用能力。
本研究纳入了6例视交叉区域表皮样囊肿患者,他们在过去5年于布尔坚科神经外科研究所接受了扩大经鼻内镜经蝶窦入路手术。
5例患者的表皮样囊肿完全切除;但所有病例均未实现表皮样囊肿包膜的完全切除。未出现视力恶化及新发局灶性神经症状的情况。1例女性患者术后出现垂体功能减退。随访期间表皮样囊肿无复发。
采用扩大经鼻内镜经蝶窦入路切除视交叉区域表皮样囊肿可能是经颅显微手术的一种替代方法。