Mastronardi Luciano, Corrivetti Francesco, Scavo Carlo Giacobbo, Roperto Raffaelino, Cacciotti Guglielmo, Campione Alberto
Unit of Neurosurgery, San Filippo Neri Hospital, Rome, Italy.
Unit of Neurosurgery, San Filippo Neri Hospital, Rome, Italy.
World Neurosurg. 2019 Jun;126:497. doi: 10.1016/j.wneu.2019.03.204. Epub 2019 Mar 27.
Video 1 describes the technique of microsurgery removal of acoustic neuromas (ANs) using new technologies. The Flexible 2μ-Thulium hand-held laser fiber (Revolix jr, LISA laser products, 7 OHG, Berlin, Germany) and Sonopet Ultrasound Aspirator (Stryker, Kalamazoo, Michigan, USA) can be used for a safe and facilitated opening of the internal auditory canal (IAC). We illustrate the operative technique used on a surgical series of 111 cases operated on during the past 8 years, from July 2010 to July 2018. We studied 170 consecutive patients suffering from ANs who were operated on with a microsurgical technique by the key-hole retrosigmoid approach. In 111 cases the "Sonopet" Ultrasound Aspirator was used to open the IAC and a 2μ-Thulium laser fiber was used for cutting the dura mater of the posterior aspect of petrous bone and the IAC, and it was also used to perform tumor capsule incision. From December 2017 we started to check the removal of tumor inside the IAC with a flexible endoscope 4 mm × 65 cm, (Karl Storz GmbH, Tuttlingen, Germany) in order to detect possible tumoral residue and achieve a radical tumor resection in the fundus. The use of these new technologies seems to be safe and subjectively facilitates the opening of the IAC in AN microsurgery.
视频1介绍了使用新技术显微手术切除听神经瘤（ANs）的技术。可使用柔性2微米铥手持式激光光纤（Revolix jr，LISA激光产品公司，德国柏林7 OHG）和Sonopet超声吸引器（美国密歇根州卡拉马祖的史赛克公司）安全、便捷地打开内耳道（IAC）。我们展示了过去8年（2010年7月至2018年7月）对111例患者进行手术时所采用的手术技术。我们研究了170例连续患有听神经瘤且采用锁孔乙状窦后入路显微手术技术进行手术的患者。在111例病例中，使用“Sonopet”超声吸引器打开内耳道，使用2微米铥激光光纤切割岩骨后表面和内耳道的硬脑膜，还用于进行肿瘤包膜切开。从2017年12月起，我们开始使用4毫米×65厘米的柔性内窥镜（德国图特林根的卡尔史托斯有限公司）检查内耳道内肿瘤的切除情况，以便检测可能的肿瘤残留并在底部实现肿瘤根治性切除。这些新技术的使用似乎是安全的，并且在主观上有助于听神经瘤显微手术中内耳道的打开。
