Liu Zhiyuan, Liu Jinlai, Dai Kexiang, Chen Kaile, Yu Kuo, Xiao Hongbo, Chang Hanxiao, Zhao Peng
Department of Neurosurgery, The First Affiliated Hospital of Nanjing Medical University, Nanjing, 210000, China.
Department of Neurosurgery, People's Hospital of Yangzhong City, Zhenjiang, 212200, China.
Sci Rep. 2025 Apr 1;15(1):11169. doi: 10.1038/s41598-025-96162-9.
Resection of deep cerebral lesions presents significant challenges for neurosurgeons. However, advancements in neuroendoscopic techniques have led to the adoption of endoscopic surgery via the supracerebellar infratentorial approach for addressing deep cerebral lesions located in the petroclival region, cerebellopontine angle, and pineal region. The aim of this study was to explore the curative effects and analyse the characteristics of the neuroendoscopic far-lateral supracerebellar infratentorial approach for treating these lesions. Sixteen cases of deep cerebral lesions treated with this method were reviewed, and the surgical outcomes and patients' postoperative conditions were assessed to evaluate the approach's effectiveness. Among the 16 patients, ten were diagnosed with petroclival region meningiomas, two with epidermoid cysts in the cerebellopontine angle, two with germ cell tumours in the pineal region, one with a trigeminal schwannoma, and one with a thalamic haematoma. Notably, only two patients (12.5%) experienced postoperative complications, and during follow-up, three patients (18.6%) exhibited no symptom improvement. These findings indicate that the neuroendoscopic far-lateral supracerebellar infratentorial approach enhances lesion exposure, improves the surgeon's view of the surgical field, minimizes the risk of intraoperative injury, and reduces the risk of postoperative complications, demonstrating significant potential for the clinical treatment of skull base lesions due to its effectiveness and safety.
切除深部脑病变对神经外科医生来说是一项重大挑战。然而，神经内镜技术的进步使得通过小脑上幕下入路进行内镜手术得以应用，以处理位于岩斜区、桥小脑角和松果体区的深部脑病变。本研究的目的是探讨神经内镜远外侧小脑上幕下入路治疗这些病变的疗效，并分析其特点。回顾了16例采用该方法治疗的深部脑病变患者，评估手术结果和患者术后情况，以评价该入路的有效性。16例患者中，10例诊断为岩斜区脑膜瘤，2例为桥小脑角表皮样囊肿，2例为松果体区生殖细胞瘤，1例为三叉神经鞘瘤，1例为丘脑血肿。值得注意的是，只有2例患者（12.5%）出现术后并发症，随访期间，3例患者（18.6%）症状无改善。这些结果表明，神经内镜远外侧小脑上幕下入路可增加病变暴露，改善术者对术野的视野，将术中损伤风险降至最低，并降低术后并发症风险，因其有效性和安全性，在颅底病变的临床治疗中显示出巨大潜力。
