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[经睑开颅术在颅底外科手术中的应用]

[Transpalpebral craniotomy in skull base surgery].

作者信息

Dzhindzhikhadze R S, Dreval' O N, Lazarev V A, Polyakov A V, Kambiev R L

机构信息

Russian Medical Academy of Continuous Professional Education, Barrikadnaya Str., 2/1-1, Moscow, Russia, 125993.

*Inozemtsev City Clinical Hospital, Fortunatovskaya Str., 1, Moscow, Russia, 105187.

出版信息

Zh Vopr Neirokhir Im N N Burdenko. 2018;82(2):48-58. doi: 10.17116/oftalma201882248-58.

Abstract

UNLABELLED

The concept of minimally invasive neurosurgery has significantly evolved in recent years, which is associated with improvements in diagnostics, microneurosurgical techniques, anesthesiology, and intraoperative imaging.

MATERIAL AND METHODS

We present the preliminary results of using transpalpebral craniotomy in surgery of supratentorial aneurysms and anterior cranial fossa tumors. In the period between 2015 and 2107, we used this approach in surgical treatment of 30 aneurysms (10 aneurysms in the 'cold' period of hemorrhage and 20 unruptured aneurysms) and 10 anterior cranial fossa base tumors. The approach included a superior eyelid incision and a fronto-orbital craniotomy. We retrospectively evaluated outcomes, postoperative complications, and cosmetic results after these operations. The mean follow-up period was 6 months.

RESULTS

There were no deaths, disabilities, or serious permanent approach-associated complications. All patients had expected periorbital edema that was not considered as a complication.

CONCLUSION

Transpalpebral craniotomy is a safe and effective approach to anterior cranial fossa neoplasms and anterior circle of Willis aneurysms. This approach avoids injury to the frontal and temporal muscles as well as to the facial and trigeminal nerve branches. Patients assessed the postoperative cosmetic result as excellent.

摘要

未标注

近年来,微创神经外科的概念有了显著发展,这与诊断、显微神经外科技术、麻醉学和术中成像的进步有关。

材料与方法

我们展示了经睑开颅术在幕上动脉瘤和前颅窝肿瘤手术中的初步结果。在2015年至2017年期间,我们采用这种方法对30例动脉瘤(出血“冷”期的10例动脉瘤和20例未破裂动脉瘤)和10例前颅窝底肿瘤进行了手术治疗。该方法包括上睑切口和额眶开颅术。我们回顾性评估了这些手术后的结果、术后并发症和美容效果。平均随访期为6个月。

结果

无死亡、残疾或与手术相关的严重永久性并发症。所有患者均出现预期的眶周水肿,这不被视为并发症。

结论

经睑开颅术是治疗前颅窝肿瘤和 Willis 环前部动脉瘤的一种安全有效的方法。这种方法避免了对额肌和颞肌以及面神经和三叉神经分支的损伤。患者对术后美容效果评价极佳。

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