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使用球囊辅助鼻腔入路扩大鼻内镜经蝶窦入路：病例说明

Use of balloon-assisted nasal access to augment endoscopic endonasal transsphenoidal approach: illustrative case.

作者信息

Winslow Nolan, Garst Jonathan, Klemens James J, Tsung Andrew J

机构信息

1Department of Neurosurgery, OSF Saint Francis Medical Center, Peoria, Illinois; and.

2Department of Otolaryngology, Peoria Ear, Nose, & Throat Center, Peoria, Illinois.

出版信息

J Neurosurg Case Lessons. 2022 Sep 5;4(10). doi: 10.3171/CASE22276.

DOI:10.3171/CASE22276
PMID:36083775
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9451052/
Abstract

BACKGROUND

Pituitary adenoma is a neurosurgical pathology commonly resected via endoscopic endonasal approach. Septal and nasal passage anatomy can affect the surgical corridor and may require septoplasty or other techniques for expansion.

OBSERVATIONS

The authors presented a case of pituitary macroadenoma with septal deviation with use of balloon-assisted nasal access for surgery.

LESSONS

This technique enhanced surgical width of field and instrument maneuverability via septal medialization for successful tumor resection.

摘要

背景

垂体腺瘤是一种常通过鼻内镜经鼻入路切除的神经外科病变。鼻中隔和鼻道解剖结构会影响手术通道，可能需要进行鼻中隔成形术或其他扩张技术。

观察结果

作者介绍了一例伴有鼻中隔偏曲的垂体大腺瘤病例，采用球囊辅助鼻入路进行手术。

经验教训

该技术通过鼻中隔内移增加了手术视野宽度和器械可操作性，从而成功切除肿瘤。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9e0b/9451052/353bcf34e993/CASE22276f3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9e0b/9451052/7ceff65a03df/CASE22276f1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9e0b/9451052/29e7e70fd384/CASE22276f2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9e0b/9451052/353bcf34e993/CASE22276f3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9e0b/9451052/7ceff65a03df/CASE22276f1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9e0b/9451052/29e7e70fd384/CASE22276f2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9e0b/9451052/353bcf34e993/CASE22276f3.jpg

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本文引用的文献

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Anatomic Variation for the Endoscopic Endonasal Transsphenoidal Approach.经鼻内镜颅底入路的解剖变异。
World Neurosurg. 2021 Dec;156:111-119. doi: 10.1016/j.wneu.2021.09.103. Epub 2021 Oct 2.
2
Long-Term Follow-Up After Maxillary Sinus Balloon Sinuplasty and ESS.上颌窦球囊鼻窦成形术和鼻内镜鼻窦手术后的长期随访
Ear Nose Throat J. 2023 Mar;102(3):181-187. doi: 10.1177/0145561320986030. Epub 2021 Feb 19.
3
Perioperative nasal and paranasal sinus considerations in transsphenoidal surgery for pituitary disease.垂体疾病经蝶窦手术围手术期鼻腔及鼻窦相关考量
Br J Neurosurg. 2020 Jun;34(3):246-252. doi: 10.1080/02688697.2020.1731424. Epub 2020 Feb 25.
4
Endoscopic Endonasal Transsphenoidal Surgery: History and Evolution.内镜经鼻蝶窦入路手术：历史与演变。
World Neurosurg. 2019 Jul;127:686-694. doi: 10.1016/j.wneu.2019.03.048.
5
Septoplasty: Basic and Advanced Techniques.鼻中隔成形术：基础与进阶技术。
Facial Plast Surg Clin North Am. 2017 May;25(2):161-169. doi: 10.1016/j.fsc.2016.12.002. Epub 2017 Feb 21.
6
Diagnosis and Treatment of Pituitary Adenomas: A Review.垂体腺瘤的诊断与治疗：综述
JAMA. 2017 Feb 7;317(5):516-524. doi: 10.1001/jama.2016.19699.
7
Evaluation of surgical freedom for microscopic and endoscopic transsphenoidal approaches to the sella.经显微镜和内镜经蝶入路至鞍区手术操作空间的评估。
Neurosurgery. 2015 Mar;11 Suppl 2:69-78; discussion 78-9. doi: 10.1227/NEU.0000000000000601.
8
The balloon dilating catheter as an instrument in sinus surgery.球囊扩张导管作为鼻窦手术中的一种器械。
Otolaryngol Head Neck Surg. 2008 Sep;139(3 Suppl 3):S23-6. doi: 10.1016/j.otohns.2008.05.017.
9
The transsphenoidal approach. A historical perspective.经蝶窦入路：历史回顾
Neurosurg Focus. 2005 Apr 15;18(4):e6. doi: 10.3171/foc.2005.18.4.7.
10
The prevalence of pituitary adenomas: a systematic review.垂体腺瘤的患病率：一项系统综述。
Cancer. 2004 Aug 1;101(3):613-9. doi: 10.1002/cncr.20412.