Department of Neurological Surgery, The University of Southern California Keck, School of Medicine, Los Angeles, CA, USA; Division of Neurosurgery, Department of Neurological Sciences, Università degli Studi di Napoli Federico II, Naples.
Department of Neurological Surgery, The University of Southern California Keck, School of Medicine, Los Angeles, CA, USA.
Neurosurg Clin N Am. 2023 Jul;34(3):393-402. doi: 10.1016/j.nec.2023.02.003. Epub 2023 Mar 27.
Traditionally, resection of anterior skull base meningiomas has been achieved by transcranial approaches; however, morbidity related (ie, brain retraction, sagittal sinus damage, optic nerve manipulation, and cosmetic healing) represent a limit of the approach. Minimally invasive techniques including supraorbital and endonasal endoscopic approaches (EEA) have gained consensus as surgical corridors provide direct access to the tumor via a midline approach in carefully selected patients . The supraorbital approach requires some retraction of the rectus gyrus, but it offers minimal risk of postoperative CSF leak or sinonasal morbidity compared to EEA.
传统上,前颅底脑膜瘤的切除术是通过颅外入路完成的;然而,相关的发病率(即脑牵拉、矢状窦损伤、视神经操作和美容愈合)是该方法的限制。微创技术包括眶上和经鼻内镜入路(EEA)已经得到共识,因为手术通道通过中线入路为精心选择的患者提供了直接到达肿瘤的途径。眶上入路需要一些直肌的牵拉,但与 EEA 相比,术后 CSF 漏或鼻-鼻窦发病率的风险最小。
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