Alalade Andrew F, Venturini Sara, Dorward Neil, Thomas Nick
Department of Neurosurgery, The Walton Centre NHS Foundation Trust , Liverpool , UK.
Aberdeen Royal Infirmary, NHS Grampian , Aberdeen , UK.
Br J Neurosurg. 2019 Oct;33(5):508-513. doi: 10.1080/02688697.2019.1606893. Epub 2019 Apr 24.
Endoscopic skull base surgery (ESBS) is a new subspecialty area that has become more popular over the past 20 years. It is fast evolving and the indications are getting increasingly diverse. The skill-sets also continue to significantly improve, hence, we, the authors aim to assess the current status of this unique sub-specialty within the United Kingdom. Our objectives included identifying the proportion of neurosurgeons within the United Kingdom who utilize endoscopic skull base approaches, the background training involved and how much of the overall neurosurgical workload is constituted by endoscopic skull base neurosurgery. There was also a focus on the technical nuances involved with ESBS. 45 neurosurgeons were included in this study, and a 47% response rate ( = 21) was obtained. 7 (33%) had training in ESBS during residency and 8 (38%) had some fellowship exposure to ESBS. Each respondent did an average of 1.9 endoscopic skull base courses prior to commencing their practice. The length of practice ranged from 3 to 15 years (mean - 7.2 years). Although most of the surgeons had mixed sub-specialty interests, the most commonly associated sub-specialty with ESBS was lateral skull base surgery (38%). In the United Kingdom, ESBS appears to be commonly combined with a lateral/open skull base neurosurgical practice. Most of the surgeons had their ESBS training after formal residency. Collaboration with ENT occurs more commonly for extended transphenoidal procedures.
内镜颅底手术(ESBS)是一个新的亚专业领域,在过去20年里越来越受欢迎。它发展迅速,适应证越来越多样化。技术水平也在持续显著提高,因此,本文作者旨在评估英国这一独特亚专业的现状。我们的目标包括确定英国使用内镜颅底手术方法的神经外科医生比例、所涉及的背景培训以及内镜颅底神经外科手术在神经外科总体工作量中所占的比例。研究还聚焦于ESBS所涉及的技术细节。本研究纳入了45名神经外科医生,获得了47%的回复率(n = 21)。7名(33%)医生在住院医师培训期间接受了ESBS培训,8名(38%)医生有过ESBS进修经历。每位受访者在开始执业前平均参加了1.9次内镜颅底手术课程。执业年限从3年到15年不等(平均7.2年)。尽管大多数外科医生有多种亚专业兴趣,但与ESBS最常相关的亚专业是外侧颅底手术(38%)。在英国,ESBS似乎通常与外侧/开放颅底神经外科手术相结合。大多数外科医生在正式住院医师培训后接受了ESBS培训。对于扩大经蝶窦手术,与耳鼻喉科的合作更为常见。
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