海绵窦脑膜瘤的颞下入路——简单且有效。
Subtemporal approach for cavernous sinus meningiomas - Simple and effective.
作者信息
Veldeman Michael, Rossmann Tobias, Vartiainen Nuutti, Niemela Mika
机构信息
Department of Neurosurgery, RWTH Aachen University Hospital, Aachen, Germany.
Department of Neurosurgery, University of Helsinki and Helsinki University Hospital.
出版信息
Surg Neurol Int. 2023 Jan 20;14:16. doi: 10.25259/SNI_1012_2022. eCollection 2023.
BACKGROUND
Over the past few decades, there has been a paradigm shift in treatment strategy for cavernous sinus meningiomas (CSMs). Preserving neurological function and cranial nerve (CN) decompression have become the primary goal of cases eligible for surgical treatment. Extensive skull base dissection and drilling can be avoided by approaching these lesions through a subtemporal route.
METHODS
We describe the subtemporal approach in a step-by-step fashion illustrating its advantages and pitfalls through and illustrative case.
RESULTS
The subtemporal approach to CSMs is a valuable alternative for CN decompression and maximal safe resection. We describe the technique in comparison to classical skull base approaches. Although rare, recurrence after adjuvant maximal radiation is possible leaving reoperation as the only treatment option.
CONCLUSION
The subtemporal approach offers a less invasive alternative for initial and redo CN decompression and successful symptom control in patients suffering from CSM.
背景
在过去几十年中，海绵窦脑膜瘤（CSM）的治疗策略发生了范式转变。保留神经功能和颅神经（CN）减压已成为适合手术治疗病例的主要目标。通过颞下途径处理这些病变可避免广泛的颅底解剖和钻孔。
方法
我们逐步描述颞下途径，并通过一个示例病例说明其优点和缺陷。
结果
CSM的颞下途径是CN减压和最大安全切除的一种有价值的替代方法。我们将该技术与经典颅底途径进行了比较。尽管罕见，但辅助最大剂量放疗后仍可能复发，再次手术成为唯一的治疗选择。
结论
颞下途径为CSM患者的初次和再次CN减压以及成功控制症状提供了一种侵入性较小的替代方法。
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