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经乙状窦后经耳道入路内镜切除大型前庭神经鞘瘤:手术视频及技术细节

Endoscopic resection through a retrosigmoid transmeatal approach of a large-sized vestibular schwannoma: operative video and technical nuances.

作者信息

Giovannini Sebastián J M, Caffaratti Guido, Centeno Tomas Ries, Ruella Mauro, Villamil Facundo, Marengo Ricardo, Cervio Andrés

机构信息

Department of Neurological Surgery, FLENI, Buenos Aires, Argentina.

出版信息

Neurosurg Focus Video. 2021 Oct 1;5(2):V2. doi: 10.3171/2021.7.FOCVID21106. eCollection 2021 Oct.

Abstract

Surgical management of vestibular schwannomas has improved over the last 30 years. Whereas in the past the primary goal was to preserve the patient's life, today neurological function safeguarding is the main objective, with numerous strategies involving single resection, staged resections, postoperative radiosurgery, or single radiosurgery. The retrosigmoid approach remains the primary pathway for surgical access to the cerebellopontine angle (CPA). The use of an endoscope has great advantages. It contributes to the visualization and resection of residual tumor and also reduces the need for cerebellar retraction. The authors present a fully endoscopic resection of a large-sized vestibular schwannoma with facial nerve preservation. The video can be found here: https://stream.cadmore.media/r10.3171/2021.7.FOCVID21106.

摘要

在过去30年里,前庭神经鞘瘤的外科治疗取得了进展。过去主要目标是挽救患者生命,如今主要目标是保护神经功能,有多种策略,包括单次切除、分期切除、术后放射外科治疗或单次放射外科治疗。乙状窦后入路仍是进入桥小脑角(CPA)的主要手术路径。使用内窥镜有很大优势。它有助于观察和切除残余肿瘤,还减少了小脑牵拉的需求。作者展示了一例保留面神经的大型前庭神经鞘瘤的全内镜切除术。视频可在此处查看:https://stream.cadmore.media/r10.3171/2021.7.FOCVID21106

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