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经鼻内镜鼻正中入路中鼻功能的保留:病例系列

Preservation of nasal function in paramedian endoscopic endonasal approaches: patient series.

作者信息

Suzuki Tomoharu, Komune Noritaka, Miyamoto Yusuke, Kuga Daisuke, Sangatsuda Yuhei, Murakami Daisuke, Yoshimoto Koji, Nakagawa Takashi

机构信息

Departments of Otorhinolaryngology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.

Departments of Neurosurgery, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.

出版信息

J Neurosurg Case Lessons. 2024 Jul 29;8(5). doi: 10.3171/CASE24218.

Abstract

BACKGROUND

The endoscopic endonasal approach to paramedian skull base lesions has garnered increasing attention in recent reports. However, it is still a challenging approach. While the primary objective of the approach is the maximal removal of tumors through a minimally invasive procedure, discussions of the approach rarely include information about the maximum preservation of nasal structures. This study aimed to retrospectively review the clinical outcomes of patients who had undergone an endoscopic endonasal approach to paramedian lesions, describe the technical and anatomical nuances related to this approach at the authors' institution, and discuss the maximal preservation of nasal structures.

OBSERVATIONS

The authors conducted a descriptive retrospective study of 17 surgical cases of paramedian endoscopic endonasal approaches performed jointly by otolaryngologists and neurosurgeons from August 2018 to August 2022 at a tertiary hospital.

LESSONS

The approach to the paramedian region of the skull base was examined. Creating an appropriate corridor to maximize the surgical field is essential to allow a safe and accurate procedure. From an otolaryngologist's perspective, the endoscopic modified medial maxillectomy is an essential procedure that maximizes the surgical corridor and maximally preserves nasal morphology. https://thejns.org/doi/10.3171/CASE24218.

摘要

背景

近年来的报道显示,经鼻内镜鼻内入路治疗颅底中线旁病变越来越受到关注。然而,这仍是一种具有挑战性的入路方式。虽然该入路的主要目标是通过微创手术最大限度地切除肿瘤,但关于该入路的讨论很少包含鼻结构最大程度保留的相关信息。本研究旨在回顾性分析接受经鼻内镜鼻内入路治疗中线旁病变患者的临床结果,描述作者所在机构该入路相关的技术和解剖细节,并探讨鼻结构的最大程度保留。

观察

作者对2018年8月至2022年8月在一家三级医院由耳鼻喉科医生和神经外科医生联合进行的17例经鼻内镜鼻内入路治疗中线旁病变的手术病例进行了描述性回顾性研究。

经验教训

研究了颅底中线旁区域的入路方式。创建合适的通道以最大化手术视野对于确保安全、准确的手术至关重要。从耳鼻喉科医生的角度来看,内镜改良内侧上颌骨切除术是一种重要的手术,可最大化手术通道并最大程度保留鼻形态。https://thejns.org/doi/10.3171/CASE24218

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cb66/11301591/6053a596d1c8/CASE24218_figure_1.jpg

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