Neurosurgery Department, Ibn Sina Hospital, Al-Sabah Medical Area, Kuwait City, Kuwait.
Adv Tech Stand Neurosurg. 2024;52:139-158. doi: 10.1007/978-3-031-61925-0_11.
Anterior cranial base meningiomas include those meningiomas originating from the tuberculum sellae, the planum sphenoidale, or the olfactory groove, with surgical excision being the main treatment modality for these tumors. Conventional microscopic and endoscope-assisted versions of the supraorbital keyhole approach via an eyebrow incision emerged into minimally invasive options that are frequently utilized nowadays for treating these tumors. At the early attempts of endoscope-assisted cranial surgery, it was noted that rigid endoscopes enabled overcoming the problem of suboptimal visualization when small exposures are used. The technical specifications and design of the currently available rigid endoscopes are associated with a group of unique features that define the endoscopic view and lay the basis for its superiority over the microscopic view during brain surgery. Notwithstanding, the fully endoscopic or endoscope-controlled version of the supraorbital keyhole approach is not routinely practiced by neurosurgeons, with few series published so far. In this chapter we elaborate on the surgical technique and nuances of the fully endoscopic supraorbital approach for anterior cranial base meningiomas.
From a prospective database of endoscopic procedures maintained by the senior author, clinical data, imaging studies, operative charts, and videos of cases undergoing fully endoscopic excision of anterior cranial base meningiomas via supraorbital approach were retrieved and analyzed. The pertinent literature was also reviewed.
The surgical technique of the fully endoscopic supraorbital approach for anterior cranial base meningiomas was formulated.
The fully endoscopic supraorbital approach for anterior cranial base meningiomas has many advantages over the conventional procedures. In our hands, the technique has proven to be feasible, efficient, and minimally invasive with excellent results.
颅前窝底脑膜瘤包括起源于鞍结节、蝶骨平台或嗅沟的脑膜瘤，这些肿瘤的主要治疗方式是手术切除。传统的经眉弓眶上锁孔入路显微镜下和内窥镜辅助版本已成为现今治疗这些肿瘤的微创选择。在内窥镜辅助颅底手术的早期尝试中，人们注意到刚性内窥镜能够克服在使用小切口时可视化效果不佳的问题。目前可用的刚性内窥镜的技术规格和设计与一组独特的特征相关，这些特征定义了内窥镜视图，并为其在脑外科手术中优于显微镜视图奠定了基础。然而，神经外科医生并未常规采用完全内窥镜或内窥镜控制的眶上锁孔入路，到目前为止，仅有少数系列报道。在本章中，我们详细阐述了经眶上锁孔入路完全内窥镜治疗颅前窝底脑膜瘤的手术技术和要点。
从高级作者维护的内窥镜手术的前瞻性数据库中，检索并分析了经眶上锁孔入路完全内窥镜切除颅前窝底脑膜瘤的临床资料、影像学研究、手术图表和病例视频。还回顾了相关文献。
制定了经眶上锁孔入路完全内窥镜治疗颅前窝底脑膜瘤的手术技术。
经眶上锁孔入路完全内窥镜治疗颅前窝底脑膜瘤具有许多优于传统手术的优势。在我们手中，该技术已被证明是可行的、高效的和微创的，具有极好的结果。
