Division of Neurosurgery, Toronto Western Hospital, University of Toronto, Toronto, ON, Canada.
Acta Neurochir Suppl. 2023;130:13-18. doi: 10.1007/978-3-030-12887-6_2.
Complications are not uncommon in the complex field of skull base surgery. The intrinsic relationship of lesions in this region to important neurovascular structures, dura mater, and bone may lead to significant morbidity and mortality. The evolution of endoscopic endonasal surgery has had a significant impact on this field as a less invasive option for treatment of selected lesions, but major morbidity may still occur; moreover, endoscopic approaches have been associated with higher rates of some specific complications, such as cerebrospinal fluid leaks. Based on a presented case report, the authors discuss the management of various complications associated with different approaches for resection of skull base malignancies, including epidural and intradural pneumocephalus, subdural hematoma, and subdural empyema. Important lessons learned by the senior author throughout more than 30 years of his skull base surgery practice are highlighted. The inherent risk of complications in skull base surgery emphasizes the importance of their avoidance, prevention, and learning from one's unfavorable experience so as not to repeat them.
颅底外科是一个复杂的领域，并发症并不罕见。该区域病变与重要的神经血管结构、硬脑膜和骨骼之间的内在关系可能导致严重的发病率和死亡率。内镜经鼻手术的发展对这一领域产生了重大影响，因为它是一种治疗选定病变的微创选择，但仍可能发生重大并发症；此外，内镜入路与某些特定并发症（如脑脊液漏）的发生率更高有关。基于一个病例报告，作者讨论了切除颅底恶性肿瘤的不同方法相关的各种并发症的处理，包括硬膜外和硬脑膜下积气、硬膜下血肿和硬膜下脓肿。资深作者在其 30 多年的颅底外科实践中总结了重要的经验教训。颅底外科并发症的固有风险强调了避免、预防并发症以及从不利经验中吸取教训的重要性，以免重蹈覆辙。
