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经外侧眶上锁孔入路切除蝶眶脑膜瘤

Inferolateral Transorbital Endoscopic Approach for Spheno-Orbital Meningiomas.

机构信息

Department of Biomedical Sciences, Humanitas University.

Department of Otolaryngology Head and Neck Surgery.

出版信息

J Craniofac Surg. 2022 May 1;33(3):e260-e265. doi: 10.1097/SCS.0000000000008062. Epub 2021 Jul 30.

Abstract

Spheno-orbital meningiomas (SOM) are slow growing tumors that often cause proptosis and visual deficits, due to direct compression of adjacent structures or hyperostosis of surrounding bones.Traditionally, these lesions are approached via a lateral transcranial route. Recent interest in mini-invasive surgery and endoscopy brought many authors to study different trans-nasal or transorbital approaches.The authors report a surgical case series with 3 patients with proptosis due to SOM who underwent surgery in our institution via an inferolateral trans-orbital endoscopic approach. The authors described our surgical technique and the authorsretrospectively reviewed the clinical and radiological outcomes of the patients.All 3 patients had an effective orbital decompression with improvement of the proptosis and pain relief. Histological examination was possible and no intraoperative nor postoperative complications were observed.Therefore, the authors consider inferolateral trans-orbital endoscopic approach as a feasible approach for lesions involving the lateral orbit compartment arising from middle cranial fossa or from orbit itself.

摘要

蝶眶脑膜瘤(SOM)是一种生长缓慢的肿瘤,常因邻近结构的直接压迫或周围骨的骨质增生而导致眼球突出和视力减退。传统上,这些病变通过外侧颅穿通途径进行治疗。微创外科和内窥镜技术的发展引起了许多作者研究不同的经鼻或经眶入路。作者报告了 3 例因 SOM 引起的眼球突出患者的手术病例系列,这些患者在我们机构通过经眶下外侧内窥镜入路进行了手术。作者描述了我们的手术技术,并回顾性分析了患者的临床和影像学结果。所有 3 例患者的眶减压均有效,眼球突出和疼痛均得到缓解。可以进行组织学检查,且未观察到术中或术后并发症。因此,作者认为经眶下外侧内窥镜入路是一种可行的方法,适用于从中颅窝或眼眶本身起源的外侧眶腔病变。

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