Porras Jose L, Rowan Nicholas R, Mukherjee Debraj
Department of Neurosurgery, The Johns Hopkins University School of Medicine, 600 N Wolfe St., Phipps 124, Baltimore, MD 21287, USA.
Department of Otolaryngology-Head and Neck Surgery, The Johns Hopkins University School of Medicine, 601 N Caroline St., Suite 6164, Baltimore, MD 21287, USA.
Brain Sci. 2022 Dec 8;12(12):1685. doi: 10.3390/brainsci12121685.
The endoscopic endonasal approach (EEA) provides a direct trajectory to ventral skull base lesions, avoidance of brain retraction, and clear visualization of cranial nerves as they exit skull base foramina. Despite these benefits, the EEA is not without complications. Here, we review published literature highlighting complications associated with the EEA including cerebrospinal fluid (CSF) leak, cranial nerve (CN) dysfunction, pituitary gland dysfunction, internal carotid artery (ICA) injury, infection, and others; we place special emphasis on discussing the prevention of these complications. As widespread adoption of the EEA continues, it becomes critical to educate surgeons regarding potential complications and their prevention while identifying gaps in the current literature to guide future research and advances in clinical care.
鼻内镜鼻内入路（EEA）为腹侧颅底病变提供了一条直接的手术路径，可避免脑牵拉，并能清晰观察到穿出颅底孔的颅神经。尽管有这些优点，但EEA并非没有并发症。在此，我们回顾已发表的文献，重点介绍与EEA相关的并发症，包括脑脊液（CSF）漏、颅神经（CN）功能障碍、垂体功能障碍、颈内动脉（ICA）损伤、感染等；我们特别强调讨论这些并发症的预防。随着EEA的广泛应用，对外科医生进行潜在并发症及其预防的教育变得至关重要，同时找出当前文献中的空白，以指导未来的研究和临床护理的进展。
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