Goncalves N, Lubbe D E
Division of Otolaryngology, Groote Schuur Hospital, Faculty of Health Science, University of Cape Town, Cape Town, South Africa.
J Neurol Surg B Skull Base. 2020 Aug;81(4):357-368. doi: 10.1055/s-0040-1713854. Epub 2020 Aug 20.
Sphenoid wing meningiomas are benign tumors that can result in proptosis, visual impairment, and pain. Traditional open surgical approaches are associated with significant morbidity. Transorbital endoscopic surgery has been developed as a minimally invasive approach to gain access to these tumors and address the main presenting symptoms. Case series reporting transorbital endoscopic resection of sphenoid wing meningiomas using combined endonasal, pre-caruncular, and extended superior eyelid approaches have demonstrated stable and/or improved short- and medium-term visual outcomes. Earlier medial optic nerve decompression appears to result in more favorable long-term visual outcomes. Transorbital endoscopic surgery therefore represents an emerging minimally invasive alternative to deal with these challenging lesions.
蝶骨嵴脑膜瘤是一种良性肿瘤,可导致眼球突出、视力损害和疼痛。传统的开放手术方法会带来较高的发病率。经眶内镜手术已发展成为一种微创方法,用于治疗这些肿瘤并解决主要症状。病例系列报道了使用鼻内联合、泪阜前和扩大上睑入路经眶内镜切除蝶骨嵴脑膜瘤,显示出短期和中期视力结果稳定和/或改善。早期的视神经内侧减压似乎能带来更有利的长期视力结果。因此,经眶内镜手术是处理这些具有挑战性病变的一种新兴微创替代方法。