Singh Harminder, Essayed Walid I, Schwartz Theodore H
Department of Neurosurgery, Stanford University School of Medicine, Stanford, CA, United States; Department of Neurosurgery, Santa Clara Valley Medical Center, San Jose, CA, United States.
Department of Neurosurgery, Brigham and Women's Hospital, Boston, MA, United States.
Handb Clin Neurol. 2020;170:217-225. doi: 10.1016/B978-0-12-822198-3.00042-2.
In this chapter, we describe advances in endoscopic endonasal surgery that have impacted skull base meningioma surgery. After reviewing the technical innovations in endoscopy, we describe the advances as they relate to each surgical step. We discuss preoperative planning and approach and the utility of neuronavigation and neuromonitoring. We then discuss endoscopic instrumentation, technology for tumor debulking (ultrasonic aspirators, radiofrequency ablators, suction debriders), and hemostatic agents as they relate to tumor resection and hemostasis. In the end, we discuss techniques of skull base reconstruction and closure (nasoseptal flap, gasket seal and bilayer button).
在本章中，我们描述了影响颅底脑膜瘤手术的鼻内镜手术进展。在回顾了内镜技术创新之后，我们将按与每个手术步骤相关的情况来描述这些进展。我们讨论术前规划与入路以及神经导航和神经监测的作用。然后，我们将讨论与肿瘤切除和止血相关的内镜器械、肿瘤减容技术（超声吸引器、射频消融器、吸引清创器）和止血剂。最后，我们讨论颅底重建和封闭技术（鼻中隔瓣、垫片密封和双层纽扣）。
