Finger Guilherme, Wu Kyle C, Gosal Jaskaran S, Jawad Basit, Vignolles-Jeong Joshua, Carrau Ricardo L, Prevedello Daniel M
Departments of Neurosurgery and.
Otolaryngology, The Ohio State University Wexner Medical Center, Columbus; and.
Neurosurg Focus Video. 2023 Jul 1;9(1):V4. doi: 10.3171/2023.4.FOCVID22150. eCollection 2023 Jul.
Cushing's adenoma invading the cavernous sinus requires aggressive resection to be cured. MRI is frequently inconclusive for identifying microadenomas, and visualizing the involvement of the medial cavernous sinus is even more challenging. In this video, the authors present a patient with an adrenocorticotropic hormone (ACTH)-producing microadenoma with doubtful left medial cavernous sinus involvement on MRI. She underwent an endoscopic endonasal exploration of the medial compartment of the cavernous sinus. The abnormally thickened wall, confirmed by intraoperative endoscopic endonasal ultrasound, was safely excised using the "interdural peeling" technique. Complete resection of the tumor resulted in normalization of her postoperative cortisol levels and disease remission with no complications. The video can be found here: https://stream.cadmore.media/r10.3171/2023.4.FOCVID22150.
侵袭海绵窦的库欣腺瘤需要积极切除才能治愈。MRI在识别微腺瘤方面常常无法得出明确结论，而可视化海绵窦内侧的受累情况则更具挑战性。在本视频中，作者展示了一名患有分泌促肾上腺皮质激素（ACTH）的微腺瘤的患者，MRI显示左侧海绵窦内侧受累情况存疑。她接受了海绵窦内侧腔的鼻内镜探查。术中通过鼻内镜超声确认的异常增厚的壁，使用“硬膜间剥离”技术安全切除。肿瘤的完全切除使她术后皮质醇水平恢复正常，疾病缓解，且无并发症。视频可在此处查看：https://stream.cadmore.media/r10.3171/2023.4.FOCVID22150 。
