Department of Neurosurgery, Qilu Hospital of Shandong University and Institute of Brain and Brain-Inspired Science, Shandong University, Jinan, Shandong Province, China; Shandong Key Laboratory of Brain Function Remodeling, Jinan, Shandong Province, China.
Department of Neurosurgery, Qilu Hospital of Shandong University and Institute of Brain and Brain-Inspired Science, Shandong University, Jinan, Shandong Province, China; Shandong Key Laboratory of Brain Function Remodeling, Jinan, Shandong Province, China.
World Neurosurg. 2019 Jun;126:537-540. doi: 10.1016/j.wneu.2019.02.128. Epub 2019 Mar 4.
This report discusses the risks and complications of using the extended endoscopic endonasal transsphenoidal approach (EEETA) in a special craniopharyngioma case to caution neurosurgeons.
A 38-year-old woman with craniopharyngioma underwent EEETA surgery. Her anterior cerebral artery was punctured intraoperatively and clipped using an aneurysm clip through the nose in an emergency procedure.
The coexistence of severe calcified craniopharyngiomas, especially with sharp calcified spurs, a narrow distance between the anterior communicating artery and the planum sphenoidale, and a narrow distance between the bilateral internal carotid arteries is a significant warning signal during EEETA for craniopharyngiomas. In this circumstance, it may be preferable to use open microsurgical approaches. If the anterior communicating artery or anterior cerebral artery is punctured during EEETA, another method is available to fix the problem using an aneurysm clip through the nose, and not only endovascular embolization.
本报告讨论了在特殊颅咽管瘤病例中使用扩展经鼻内镜颅底入路（EEETA）的风险和并发症，以警示神经外科医生。
一名 38 岁女性患有颅咽管瘤，接受了 EEETA 手术。术中其大脑前动脉被刺破，紧急情况下通过鼻腔使用动脉瘤夹夹闭。
严重钙化颅咽管瘤的共存，特别是伴有尖锐钙化刺、前交通动脉与蝶骨平台之间距离狭窄以及双侧颈内动脉之间距离狭窄，是 EEETA 治疗颅咽管瘤的重要警示信号。在这种情况下，可能更倾向于使用开放式显微外科入路。如果在 EEETA 过程中刺破前交通动脉或大脑前动脉，可以通过鼻腔使用动脉瘤夹来解决问题，而不仅仅是血管内栓塞。
