Dong Xiao, Wang Xiaoyu, Shao Anwen, Zhang Jianmin, Hong Yuan
Department of Neurosurgery, The Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China.
Brain Research Institute, Zhejiang University, Hangzhou, China.
Front Surg. 2021 May 12;8:654837. doi: 10.3389/fsurg.2021.654837. eCollection 2021.
Ventral medial pontine cavernous malformations are challenging due to the location in eloquent tissue, surrounding critical anatomy, and potential symptomatic bleeding. Conventional approaches, such as anterolateral, lateral and dorsal approach, are associated with high risk of deleterious consequences due to excessive traction and damage to the surrounding tissues. The authors present an endoscopic endonasal approach for the resection of midline ventral pontine cavernous malformations, which follows principles of optimal access to brainstem cavernous malformations as the "two-point method." No CSF leak or any other complications are obtained. The successful outcomes indicate that an individualized approach should be chosen before the surgery for brainstem cavernous malformations. With the advance of techniques, endoscopic endonasal approach could provide the most direct route to ventral pontine lesions with safety and efficiency.
由于位于明确的脑组织区域、周围有重要解剖结构以及存在潜在的症状性出血，脑桥腹内侧海绵状血管畸形的治疗具有挑战性。传统手术入路，如前外侧、外侧和背侧入路，因过度牵拉和对周围组织的损伤而导致有害后果的风险较高。作者介绍了一种用于切除脑桥腹侧中线海绵状血管畸形的内镜鼻内入路，该入路遵循“两点法”这一最佳进入脑干海绵状血管畸形的原则。未出现脑脊液漏或任何其他并发症。成功的结果表明，对于脑干海绵状血管畸形手术，术前应选择个体化的手术入路。随着技术的进步，内镜鼻内入路能够安全、高效地为脑桥腹侧病变提供最直接的手术路径。
