Zhao Kevin, Quillin Joseph, Liu James K
Department of Neurological Surgery, Center for Skull Base and Pituitary Surgery, Rutgers University, New Jersey Medical School, Newark; Saint Barnabas Medical Center, RWJ Barnabas Health, Livingston, New Jersey.
Neurosurg Focus Video. 2021 Jan 1;4(1):V9. doi: 10.3171/2020.10.FOCVID2067. eCollection 2021 Jan.
In this illustrative video, the authors demonstrate resection of a superior vermian arteriovenous malformation (AVM) using the endoscopic-assisted parieto-occipital interhemispheric precuneal transtentorial approach. Lateral positioning allows for gravity-assisted access to the interhemispheric fissure without retractors. The parieto-occipital trajectory is useful in patients who have a steep tentorial angle and avoids manipulation of the occipital lobe and visual cortex. In addition, the authors utilize an angled endoscope, which allows full inspection of the resection bed after AVM removal to visualize areas hidden from the microsurgical view to minimize the chance of residual disease in a deep corridor with multiple visual obstructions. The video can be found here: https://youtu.be/hk9nIIdtqbI.
在这段演示视频中，作者展示了使用内镜辅助顶枕叶间脑楔前经小脑幕入路切除小脑上蚓部动静脉畸形（AVM）。侧卧位可在不使用牵开器的情况下借助重力进入大脑半球间裂。顶枕叶入路对小脑幕角陡峭的患者有用，可避免对枕叶和视觉皮层的操作。此外，作者使用了一个成角内镜，在切除AVM后可对切除腔进行全面检查，以可视化显微手术视野中看不到的区域，从而将在有多个视觉障碍的深部通道中残留病变的几率降至最低。视频链接如下：https://youtu.be/hk9nIIdtqbI 。
