Gao Hua, Liu Chunhui, Zhang Yazhuo
Beijing neurosurgical institute, Capital Medical University, China; Key laboratory of central nervous system injury, Beijing, China.
Beijing neurosurgical institute, Capital Medical University, China.
Clin Neurol Neurosurg. 2018 Jul;170:102-105. doi: 10.1016/j.clineuro.2018.05.009. Epub 2018 May 14.
The endoscope has traditionally been used in neurosurgery to access a lesion within a natural body cavity. The challenge has been to access and resect deep-seated intraparenchymal lesions using a minimally invasive endoscopic technique. Endoscopic endonasal trans-sphenoidal surgery has gained increasing acceptance by otolaryngologists and neurosurgeons. Surgical procedures of the skull base include exposure, resection, and base reconstruction. These approaches start at the sphenoid sinus, which provides a reference point to important vascular and neural structures. The endoscopic endonasal approach is optimal in paramedian ventral skull base tumors, allowing wide access to the ventral skull base regions and allowing early devascularization of the tumor without retraction of the brain. Limited exposure results in limited "injury" to surrounding tissue and consequently reduced post-operative pain, a shorter length of hospital stay, a reduction in the time to return to work, and decreased overall cost.
传统上，内窥镜已被用于神经外科手术中，以进入自然体腔内的病变部位。挑战在于使用微创内窥镜技术来进入并切除脑实质内深部病变。鼻内镜经蝶窦手术越来越受到耳鼻喉科医生和神经外科医生的认可。颅底手术包括暴露、切除和颅底重建。这些手术从蝶窦开始，蝶窦为重要的血管和神经结构提供了一个参考点。鼻内镜经鼻入路对于中线旁腹侧颅底肿瘤是最佳选择，它能广泛进入腹侧颅底区域，且无需牵拉脑组织就能早期实现肿瘤去血管化。有限的暴露对周围组织造成的“损伤”有限，从而减轻术后疼痛、缩短住院时间、减少恢复工作的时间并降低总体费用。
