Rutkowski Martin J
Department of Neurosurgery, Medical College of Georgia at Augusta University, Augusta, Georgia, United States.
J Neurol Surg B Skull Base. 2021 Apr 8;83(Suppl 3):e621-e622. doi: 10.1055/s-0041-1724116. eCollection 2022 Aug.
The following operative video demonstrates surgical tenets and nuances of the pretemporal transcavernous approach in an unusual case of a 33-year-old patient suffering new onset diplopia and a third nerve palsy due to an orbito-cavernous oculomotor schwannoma. Near total resection was accomplished through an extended pterional craniotomy with pretemporal transcavernous exposure of her lesion, resulting in resolution of her preoperative oculomotor palsy and visual dysfunction. When combined with extended pterional and modified frontotemporal orbitozygomatic approaches, the pretemporal transcavernous approach provides excellent surgical access to the parasellar region including the superior orbital fissure and cavernous sinus. Meticulous dissection and early identification of tissue planes, including cranial nerve and vascular anatomy, allows for safe removal of tumors arising in this region. The link to the video can be found at: https://youtu.be/EuIRTP7wWBQ .
以下手术视频展示了颞前经海绵窦入路的手术原则和细微之处，该病例为一名33岁患者，因眶-海绵窦动眼神经鞘瘤出现新发复视和动眼神经麻痹。通过扩大翼点开颅术并经颞前经海绵窦暴露病变，实现了近全切除，患者术前的动眼神经麻痹和视觉功能障碍得以缓解。当与扩大翼点入路和改良额颞眶颧入路相结合时，颞前经海绵窦入路可提供极佳的手术通道，用于显露包括眶上裂和海绵窦在内的鞍旁区域。细致的解剖以及对包括颅神经和血管解剖结构在内的组织层面的早期识别，有助于安全切除该区域产生的肿瘤。视频链接为：https://youtu.be/EuIRTP7wWBQ 。
