Hanakita Shunya
Department of Neurosurgery, Saitama Medical University/Center.
No Shinkei Geka. 2024 Jul;52(4):736-748. doi: 10.11477/mf.1436204973.
Patients with parasellar meningiomas often initially present with visual impairment. Understanding the surrounding anatomy is essential when preparing for surgery of parasellar meningiomas, as this region includes various crucial neurovascular structures. Historically, invasive craniotomy, such as the orthozygomatic approach or zygotomy, has often been attempted to access the region; however, the use of these invasive approaches has become less common, because of the accumulation of anatomical knowledge, as well as the development of surgical techniques and devices, including the endonasal endoscopic approach. Herein, we summarize how we perform surgery for parasellar meningiomas, and outline tips and pitfalls that could be useful for young residents and trainees who are new to the skull base field.
鞍旁脑膜瘤患者最初常表现为视力障碍。在准备鞍旁脑膜瘤手术时,了解周围解剖结构至关重要,因为该区域包含各种关键的神经血管结构。从历史上看,常尝试采用侵入性开颅手术,如经颧弓入路或颧弓切开术来进入该区域;然而,由于解剖学知识的积累以及手术技术和设备的发展,包括鼻内镜入路,这些侵入性方法的使用已变得不那么常见。在此,我们总结了我们进行鞍旁脑膜瘤手术的方法,并概述了一些技巧和陷阱,这可能对刚接触颅底领域的年轻住院医师和实习生有用。