Sanuki Tetsuji, Sumiya Shogo
Department of Otolaryngology-Head and Neck Surgery, Nagoya City University, Graduate School of Medical Sciences.
No Shinkei Geka. 2022 May;50(3):535-543. doi: 10.11477/mf.1436204584.
Endoscopic endonasal skull base surgery has become popular due to its minimally invasive nature to the patient and the development of various medical devices. The reason why it is considered less invasive is that it is possible to reach the anterior skull base lesion using the corridor of the nasal cavity and paranasal sinuses. The roles of the nasal sinuses include acting as breathing pathways, warming, humidifying, and filtering of inhaled air, olfaction, and being a resonant cavity, all of which are important for a comfortable life, and the loss of these functions reduces the quality of life. Therefore, to perform endoscopic endonasal skull base surgery in a minimally invasive and safe manner, it is necessary to understand the anatomy of the nasal sinuses to reach anterior skull base lesions while preserving nasal structures as much as possible. This article describes the normal local anatomy of the nasal cavity and the paranasal sinuses, as well as the surgical techniques, especially the anterior skull base approach and the pterygopalatine fossa approach, for endoscopic endonasal skull base surgery.
由于对患者具有微创性以及各种医疗设备的发展，鼻内镜下经鼻颅底手术已变得流行。它被认为侵入性较小的原因在于，利用鼻腔和鼻窦的通道能够到达前颅底病变部位。鼻窦的作用包括作为呼吸通道、对吸入空气进行加温、加湿和过滤、嗅觉功能以及作为共鸣腔，所有这些对于舒适生活都很重要，而这些功能的丧失会降低生活质量。因此，为了以微创且安全的方式进行鼻内镜下经鼻颅底手术，有必要了解鼻窦的解剖结构，以便在尽可能保留鼻腔结构的同时到达前颅底病变部位。本文描述了鼻腔和鼻窦的正常局部解剖结构，以及鼻内镜下经鼻颅底手术的手术技术，特别是前颅底入路和翼腭窝入路。
