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颅咽管瘤的鼻内镜经鼻入路:典型病例及青年神经外科医生的技术细节

Endoscopic Endonasal Approach in Craniopharyngiomas: Representative Cases and Technical Nuances for the Young Neurosurgeon.

作者信息

Aragón-Arreola Jorge F, Marian-Magaña Ricardo, Villalobos-Diaz Rodolfo, López-Valencia Germán, Jimenez-Molina Tania M, Moncada-Habib J Tomás, Sangrador-Deitos Marcos V, Gómez-Amador Juan L

机构信息

Department of Neurosurgery at National Institute of Neurology and Neurosurgery "Manuel Velasco Suárez", Mexico City P.C. 14260, Mexico.

出版信息

Brain Sci. 2023 Apr 28;13(5):735. doi: 10.3390/brainsci13050735.

Abstract

Craniopharyngiomas (CPs) are Rathke's cleft-derived benign tumors originating most commonly in the dorsum sellae and representing 2% of intracranial neoplasms. CPs represent one of the more complex intracranial tumors due to their invasive nature, encasing neurovascular structures of the sellar and parasellar regions, making its resection a major challenge for the neurosurgeon with important postoperative morbidity. Nowadays, an endoscopic endonasal approach (EEA) provides an "easier" way for CPs resection allowing a direct route to the tumor with direct visualization of the surrounding structures, diminishing inadvertent injuries, and providing a better outcome for the patient. In this article, we include a comprehensive description of the EEA technique and nuances in CPs resection, including three illustrated clinical cases.

摘要

颅咽管瘤(CPs)是源自拉克氏囊的良性肿瘤,最常见于鞍背,占颅内肿瘤的2%。由于其侵袭性,颅咽管瘤是较为复杂的颅内肿瘤之一,它包裹着鞍区和鞍旁区域的神经血管结构,这使得其切除对神经外科医生来说是一项重大挑战,术后常伴有严重并发症。如今,内镜鼻内入路(EEA)为颅咽管瘤的切除提供了一种“更简便”的方法,该方法可直接通向肿瘤,能直接观察周围结构,减少意外伤害,并为患者带来更好的治疗效果。在本文中,我们全面描述了内镜鼻内入路技术以及颅咽管瘤切除术中的细微差别,包括三个配有插图的临床病例。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9cd6/10216292/2e66cffabb52/brainsci-13-00735-g001.jpg

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