Department of Neurological Surgery, The Ohio State University, Columbus, OH, USA.
Department of Pediatric Neuroendocrinology and Pediatric Endocrinology, Jeser Amarante Faria Children's Hospital, Neurological and Neurosurgical Clinic of Joinville, Joinville, Brazil.
J Neurosurg Sci. 2021 Apr;65(2):169-180. doi: 10.23736/S0390-5616.21.05170-5. Epub 2021 Jan 22.
Anterior skull base malignancies are rare and comprise distinct histological entities. Surgery encompasses the traditional craniofacial resections (CFR), and more recently, endoscopic endonasal approaches (EEA) or a hybrid cranioendoscopic (CEA) technique. Although the CFR is still considered the "gold-standard;" there is growing evidence supporting that EEA yield equivalent oncologic outcomes with less morbidity in well-selected cases. Therefore, this article aims to review the current state-of-art in addressing anterior cranial base malignancies using expanded endoscopic endonasal approaches (EEA) with particular references to surgical anatomy and nuances of hybrid cranioendoscopic techniques. Cadaveric dissections and illustrative cases are presented to detail our current surgical technique allied with tailored adjuvant therapies, and treatment strategies are further discussed based on tumor histology.
前颅底恶性肿瘤较为罕见，包含多种不同的组织学实体。手术包括传统的颅面切除术（CFR），以及最近发展起来的经鼻内镜入路（EEA）或混合颅内镜（CEA）技术。尽管 CFR 仍然被认为是“金标准”，但越来越多的证据表明，在选择合适的病例中，EEA 可获得与 CFR 相当的肿瘤学结果，同时具有更低的发病率。因此，本文旨在通过扩展的经鼻内镜入路（EEA）来综述前颅底恶性肿瘤的治疗现状，特别参考了手术解剖学和混合颅内镜技术的细节。通过尸体解剖和实例说明来详细介绍我们目前的手术技术，以及针对性的辅助治疗，并且根据肿瘤的组织学进一步讨论治疗策略。
