Pojskić Mirza, Arnautović Kenan I
Department of Neurosurgery, University of Marburg, Marburg, Germany.
Semmes Murphey Neurologic and Spine Institute, Department of Neurosurgery, University of Tennessee Health Science Center, Memphis, Tennessee, United States.
J Neurol Surg B Skull Base. 2018 Feb;79(2):S223-S224. doi: 10.1055/s-0037-1620240. Epub 2018 Jan 16.
In this video clip, the authors present the resection of a tuberculum sellae meningioma with compression of the left optic nerve and a chiasm ( Fig. 1 ) through a standard cranial orbital (CO) skull base approach. 1 2 3 The key step in the tumor resection was microsurgical dissection of left and right A1 segments of the anterior cerebral artery and the anterior communicating artery and the separation of the tumor from these vascular structures. This was followed by careful separation of the meningioma from both optic nerves, the chiasm and the pituitary stalk. The final step was coagulation and resection of the tumor origin on the dura of the tuberculum sellae, devascularizing the tumor. Once this was achieved, the tumor was removed. Using this approach, an optimal surgical corridor to the sellar area was provided while minimizing the retraction of frontal and temporal lobes. The link to the video can be found at: https://youtu.be/O59Fj2dNXB0 .
在这段视频片段中，作者展示了通过标准颅眶（CO）颅底入路切除压迫左侧视神经和视交叉的鞍结节脑膜瘤（图1）。1 2 3肿瘤切除的关键步骤是对大脑前动脉左右A1段和前交通动脉进行显微手术解剖，并将肿瘤与这些血管结构分离。随后，小心地将脑膜瘤与双侧视神经、视交叉和垂体柄分离。最后一步是对鞍结节硬脑膜上的肿瘤起源部位进行凝固和切除，使肿瘤血管化。一旦完成这一步，肿瘤即可切除。采用这种方法，在尽量减少额叶和颞叶牵拉的同时，提供了通往鞍区的最佳手术通道。视频链接可在以下网址找到：https://youtu.be/O59Fj2dNXB0 。
