文献检索文档翻译深度研究
Suppr Zotero 插件Zotero 插件
邀请有礼套餐&价格历史记录

新学期,新优惠

限时优惠:9月1日-9月22日

30天高级会员仅需29元

1天体验卡首发特惠仅需5.99元

了解详情
不再提醒
插件&应用
Suppr Zotero 插件Zotero 插件浏览器插件Mac 客户端Windows 客户端微信小程序
高级版
套餐订阅购买积分包
AI 工具
文献检索文档翻译深度研究
关于我们
关于 Suppr公司介绍联系我们用户协议隐私条款
关注我们

Suppr 超能文献

核心技术专利:CN118964589B侵权必究
粤ICP备2023148730 号-1Suppr @ 2025

经额眶前颞颅底入路联合前床突切除术切除大型左侧岩斜脑膜瘤:“解缠绕”包绕的颈内动脉和视神经减压:二维手术视频。

Cranioorbital Pretemporal Skull Base Approach with Anterior Clinoidectomy for Removal of Large Left Clinoid Meningioma: "Unwrapping" Encircled Internal Carotid Artery and Decompressing Optic Nerve: 2-Dimensional Operative Video.

机构信息

Clinic of Neurosurgery, University Clinical Center of Vojvodina, Novi Sad, Serbia; Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia.

Department of Neurosurgery, The University of Tennessee Health Science Center, Memphis, Tennessee, USA.

出版信息

World Neurosurg. 2024 Feb;182:43-44. doi: 10.1016/j.wneu.2023.11.033. Epub 2023 Nov 14.


DOI:10.1016/j.wneu.2023.11.033
PMID:37972917
Abstract

Clinoidal meningiomas are meningiomas arising from or in the vicinity of the anterior clinoid process. Despite advanced microsurgical techniques, clinoidal meningiomas remain challenging. Extradural anterior clinoidectomy with optical unroofing remains an important tool in skull base surgery, which provides a safe operative corridor, facilitating greater extent of resection and enhancing overall outcome, particularly visual function. A 66-year-old woman presented with history of visual disturbances. Magnetic resonance imaging revealed a dural-based tumor consistent with a large left clinoidal meningioma, with tumor wrapping (encircling) around the left trunk and internal carotid artery (ICA) bifurcation, elevating the left middle cerebral artery M1 segment, and invading the left optic canal. Left cranio-orbital craniotomy with pretemporal exposure was used (Video 1). A high-speed diamond drill with irrigation completed the extradural anterior clinoidectomy and optical canal unroofing. Use of a 1-mm Kerrison rongeur should be done with utmost care. The tumor was unwrapped via meticulous piecemeal removal. Final dissection and ICA unwrapping was done when the tumor was debulked enough that dissecting it off the artery was safe and under less tension. Due to its obscurity, final decompression of the left optic nerve with incision and opening of the falciform ligament was performed at the end of the procedure. Postoperative neuro-ophthalmologic examination showed a grossly unchanged left visual field with some visual acuity improvement. Resection of tumor encircling the ICA has been described previously; however, to the best of our knowledge, this is the first video describing removal of a tumor surrounding the ICA (perfomed by senior author K.I.A.), essentially "unwrapping" the left ICA trunk and its bifurcation. The patient consented to publication.

摘要

颅眶沟通性脑膜瘤是起源于前床突或邻近前床突的脑膜瘤。尽管显微外科技术不断发展,颅眶沟通性脑膜瘤仍然是极具挑战性的。颅眶沟通性脑膜瘤切除术采用硬膜外前方床突切除术和视神经管减压术仍然是颅底手术中的重要工具,它提供了一个安全的手术通道,有助于更大程度的切除肿瘤,并提高整体预后,特别是视觉功能。一位 66 岁的女性因视力障碍就诊。磁共振成像显示一硬脑膜肿瘤,符合左侧大型颅眶沟通性脑膜瘤,肿瘤包裹(环绕)左侧颈内动脉主干和颈内动脉分叉处,抬高左侧大脑中动脉 M1 段,并侵犯左侧视神经管。采用经额颞部颅眶开颅术(视频 1)。高速钻石钻头冲洗完成硬膜外前方床突切除术和视神经管减压术。使用 1 毫米的 Kerrison 咬骨钳应格外小心。通过细致的分片切除来剥离肿瘤。当肿瘤足够缩小,从动脉上解剖下来是安全且张力较小的情况下,进行最终的解剖和颈内动脉松解。由于其位置隐蔽,在手术结束时进行左侧视神经的最终减压,切开和打开镰状韧带。术后神经眼科检查显示左眼视野大体不变,但视力稍有改善。以前曾描述过包裹颈内动脉的肿瘤切除术;然而,据我们所知,这是第一个描述切除环绕颈内动脉的肿瘤(由资深作者 K.I.A. 完成)的视频,基本上是“解开”左侧颈内动脉主干及其分叉。患者同意发表。

相似文献

[1]
Cranioorbital Pretemporal Skull Base Approach with Anterior Clinoidectomy for Removal of Large Left Clinoid Meningioma: "Unwrapping" Encircled Internal Carotid Artery and Decompressing Optic Nerve: 2-Dimensional Operative Video.

World Neurosurg. 2024-2

[2]
The "no-drill" technique of anterior clinoidectomy: a cranial base approach to the paraclinoid and parasellar region.

Neurosurgery. 2009-3

[3]
Extradural clinoidectomy for resection of clinoidal meningioma.

Neurosurg Focus. 2017-10

[4]
Impact of anterior clinoidectomy on visual function after resection of meningiomas in and around the optic canal.

Acta Neurochir (Wien). 2013-5-11

[5]
How I do it : anterior clinoidectomy and optic canal unroofing for microneurosurgical management of ophthalmic segment aneurysms.

Acta Neurochir (Wien). 2013-4-7

[6]
Giant anterior clinoidal meningiomas: surgical technique and outcomes.

J Neurosurg. 2012-8-17

[7]
Tailored frontotemporoorbitozygomatic (FTOZ) craniotomy for a large anterior clinoidal meningioma.

Clin Neurol Neurosurg. 2023-5

[8]
Cranio-Orbital Pretemporal Approach With Extradural Anterior Clinoidectomy and Optic Nerve Release for Microsurgical Resection of Large Tuberculum Sellae Meningioma-Reversal of Preoperative Bilateral Blindness: 2-Dimensional Operative Video.

Oper Neurosurg. 2023-2-1

[9]
High incidence of optic canal involvement in clinoidal meningiomas: rationale for aggressive skull base approach.

Acta Neurochir (Wien). 2008-11

[10]
Surgical unroofing of the optic canal and visual outcome in basal meningiomas.

Acta Neurochir (Wien). 2012-9-4

文献AI研究员

20分钟写一篇综述,助力文献阅读效率提升50倍

立即体验

用中文搜PubMed

大模型驱动的PubMed中文搜索引擎

马上搜索

推荐工具

医学文档翻译智能文献检索