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联合鼻内镜经结节和经斜坡入路治疗后颅窝大型神经肠囊肿：1例报告及文献复习

Combined endoscopic endonasal transtubercular and transclival approaches for large neurenteric cyst in posterior cranial fossa: A case report and literature review.

作者信息

Sato Daisuke, Hasegawa Hirotaka, Shin Masahiro, Kondo Kenji, Saito Nobuhito

机构信息

Department of Neurosurgery, The University of Tokyo Hospital, Tokyo, Japan.

Department of Otolaryngology, The University of Tokyo Hospital, Tokyo, Japan.

出版信息

Surg Neurol Int. 2021 Nov 8;12:554. doi: 10.25259/SNI_648_2021. eCollection 2021.

DOI:10.25259/SNI_648_2021
PMID:34877040
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8645466/
Abstract

BACKGROUND

Intracranial neurenteric cysts (NCs) are extremely rare tumors that more commonly involve the posterior fossa than any other cranial part. While transcranial skull base surgery has been the mainstay of treatment, the utility of endoscopic transnasal surgery (ETS) remains to be established.

CASE DESCRIPTION

We report a case of a large posterior fossa NC extensively involving the suprasellar region, cerebellopontine angle, and prepontine cistern, which we successfully resected with ETS through a combination of transtubercular and transclival routes. Before surgery, the patient presented with abducens nerve and pseudobulbar palsies, which resolved within 2 weeks postoperatively. The patient remained free from recurrence for 3 years postoperatively.

CONCLUSION

Extended ETS may offer a minimally invasive option for the posterior fossa NC, extensively occupying the ventral space of the brainstem.

摘要

背景

颅内神经肠囊肿（NCs）是极其罕见的肿瘤，相较于其他任何颅部区域，更常累及后颅窝。虽然经颅颅底手术一直是主要的治疗方法，但内镜经鼻手术（ETS）的效用仍有待确定。

病例描述

我们报告了一例大型后颅窝NC，广泛累及鞍上区、桥小脑角和脑桥前池，我们通过经结节和经斜坡联合入路，成功地用ETS将其切除。术前，患者出现外展神经和假性延髓麻痹，术后2周内症状消失。术后3年患者无复发。

结论

扩大的ETS可能为广泛占据脑干腹侧空间的后颅窝NC提供一种微创选择。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f913/8645466/5d75335386df/SNI-12-554-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f913/8645466/d8cf76919ef8/SNI-12-554-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f913/8645466/287e5d60d183/SNI-12-554-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f913/8645466/5d75335386df/SNI-12-554-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f913/8645466/d8cf76919ef8/SNI-12-554-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f913/8645466/287e5d60d183/SNI-12-554-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f913/8645466/5d75335386df/SNI-12-554-g003.jpg

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The limits of the endoscopic endonasal transclival approach for posterior fossa tumors.
经鼻内镜经斜坡入路治疗后颅窝肿瘤的局限性。
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Role of endoscopic transnasal surgery for skull base chondrosarcoma: a retrospective analysis of 19 cases at a single institution.内镜经鼻手术治疗颅底软骨肉瘤的作用：单机构 19 例回顾性分析。
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