内镜扩大前颅底颅骨切除术治疗骨化脑膜瘤的手术要点。
Surgical nuances of the expanded endoscopic anterior skull base craniectomy for hyperostotic meningioma resection.
机构信息
Department of Neurological Surgery, The Ohio State University Medical Center, N-1049 Doan Hall, 410 West 10th, Avenue, Columbus, OH, 43210, USA.
Department of Neurological Surgery, McLaren Hospital, Bay Region, Bay City, MI, USA.
出版信息
Acta Neurochir (Wien). 2020 Jun;162(6):1269-1274. doi: 10.1007/s00701-020-04277-x. Epub 2020 Mar 15.
BACKGROUND
The rostral expanded endoscopic approach (EEA) to anterior cranial fossa (ACF) has several advantages over transcranial/craniofacial surgery, providing early access to the vascular supply of tumors and reducing morbidities of craniotomy especially that of brain retraction. This article presents endoscopic landmarks and nuances for a wide ACF corridor, with stepwise image-guided dissections highlighting surgical tricks and techniques to enhance surgical safety.
METHODS
We describe an expanded endoscopic endonasal anterior skull base craniectomy for a recurrent large olfactory groove hyperostotic meningioma, with correlated cadaveric dissections.
CONCLUSION
The widening of rostral EEA can provide a safe and feasible route to access ACF. This article highlights the specific landmarks in endoscopic anatomy with reference to the angle of visualization and bayonetted instruments.
背景
经颅内镜扩大入路（EEA）到前颅窝（ACF）相对于经颅/颅面手术有几个优势，它能更早地接触到肿瘤的血管供应，降低开颅术的发病率，特别是减少脑牵拉的发病率。本文提出了一种广泛的 ACF 通道的内镜标志和细微差别，通过逐步的图像引导解剖突出了手术技巧和技术，以提高手术安全性。
方法
我们描述了一种经扩大的内镜经鼻颅底前颅窝切除术，用于治疗复发性大型嗅沟骨化性脑膜瘤，并进行了相关的尸体解剖。
结论
扩大颅端 EEA 可以提供一个安全可行的途径来进入 ACF。本文重点介绍了内镜解剖的具体标志，参考了可视化角度和刺刀式器械。
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