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扩大蝶骨嵴入路:小儿患者颅底肿瘤手术治疗的新技术

The Extended-Sphenoid Ridge Approach: A New Technique for the Surgical Treatment of Skull Base Tumors in Pediatric Patients.

作者信息

Garcia-Navarrete Roberto, Marhx-Bracho Alfonso, Terrazo-Lluch Javier, Pérez-Gómez José Luis

机构信息

Neurosurgery Department, National Institute of Pediatrics of Mexico, Ciudad de Mexico 04530, Mexico.

Neurosurgery Department, Naval Medical Center, SEMAR, Ciudad de Mexico 04470, Mexico.

出版信息

Brain Sci. 2023 May 31;13(6):888. doi: 10.3390/brainsci13060888.

Abstract

UNLABELLED

The sphenoid ridge approach (SRA) was initially described as a surgical technique for treating vascular pathologies near the Sylvian fissure. However, limited studies have systematically explored the use of skull base techniques in pediatric patients. This study investigated an extended variation in the sphenoid ridge approach (E-SRA), which systematically removed the pterion, orbital walls (roof and lateral wall), greater sphenoid wing, and anterior clinoid process to access the base of the skull.

OBJECTIVE

This report aimed to evaluate the advantages of the extradural removal of the orbital roof, pterion, sphenoid wing, and anterior clinoid process as a complement to the sphenoid ridge approach in pediatric patients.

PATIENTS AND METHODS

We enrolled 36 patients with suspected neoplastic diseases in different regions. The E-SRA was performed to treat the patients. Patients were included based on the a priori objective of a biopsy or a total gross resection. The surgical time required to complete the approach, associated bleeding, and any complications were documented.

RESULTS

Our results demonstrated that the proposed a priori surgical goal, biopsy, or resection were successfully achieved in all cases. In addition, using the E-SRA technique was associated with a shorter operative time, minimal bleeding, and a lower incidence of complications. The most frequently encountered complications were related to dural closure.

CONCLUSIONS

The extended sphenoid ridge approach represents a safe and effective option for managing intracranial tumors in pediatrics.

摘要

未标注

蝶骨嵴入路(SRA)最初被描述为一种治疗大脑外侧裂附近血管病变的手术技术。然而,仅有有限的研究系统地探索了颅底技术在儿科患者中的应用。本研究调查了蝶骨嵴入路的一种扩展术式(E-SRA),该术式系统性地切除翼点、眶壁(眶顶和外侧壁)、大翼以及前床突以显露颅底。

目的

本报告旨在评估硬膜外切除眶顶、翼点、蝶骨翼和前床突作为儿科患者蝶骨嵴入路补充方法的优势。

患者与方法

我们纳入了36例不同部位疑似肿瘤性疾病的患者。采用E-SRA对这些患者进行治疗。基于活检或全肿瘤切除的先验目标纳入患者。记录完成该入路所需的手术时间、相关出血量以及任何并发症。

结果

我们的结果表明,所有病例均成功实现了先验手术目标,即活检或切除。此外,使用E-SRA技术手术时间更短、出血极少且并发症发生率更低。最常遇到的并发症与硬膜缝合有关。

结论

扩展蝶骨嵴入路是治疗儿科颅内肿瘤的一种安全有效的选择。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6e98/10296287/15226995e9bf/brainsci-13-00888-g001.jpg

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