用于预防脑脊液漏的3D内镜下硬膜外白滨-多伦克入路及气化前床突的处理：我的操作方法
3D-exoscopic extradural Hakuba-Dolenc approach with manipulation of pneumatized anterior clinoid process for the prevention of cerebrospinal fluid leakage: how I do it.
作者信息
Wang Long, Tang Wenlong, Pei Ao, Zhang Dong
机构信息
Department of Neurosurgery, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China.
Department of Otolaryngology, Longgang Otolaryngology Hospital & Shenzhen Key Laboratory of Otolaryngology, Shenzhen Institute of Otolaryngology, Shenzhen, Guangdong, China.
出版信息
Acta Neurochir (Wien). 2025 Jun 7;167(1):165. doi: 10.1007/s00701-025-06583-8.
BACKGROUND
Microsurgical skull base technique continues to be a crucial component in repairing intracranial vascular anomalies and resecting massive lesions.
METHODS
We described a technical modification to manipulate pneumatized anterior clinoid process (pACP) during extradural Hakuba-Dolenc approach for the precaution of postoperative cerebrofluid leakage under the direct visualization of 3D digital Aeos exoscope. The interdural dissection of lateral wall of cavernous sinus followed by ACP removal using hybrid (drilling & biting) technique was performed. A supplemental video of surgical details was also presented.
CONCLUSIONS
The hybrid clinoidectomy technique has been shown to be an effective method for preventing cerebrospinal fluid leakage, particularly during surgical manipulations involving pneumatized skull base bone.
背景
显微外科颅底技术仍然是修复颅内血管畸形和切除巨大病变的关键组成部分。
方法
我们描述了一种技术改良，即在硬膜外Hakuba-Dolenc入路中，在3D数字Aeos内窥镜直接可视化下操作气化的前床突（pACP），以预防术后脑脊液漏。在进行海绵窦外侧壁硬膜间解剖后，采用混合（钻孔和咬除）技术切除前床突。还展示了手术细节的补充视频。
结论
混合性前床突切除术已被证明是预防脑脊液漏的有效方法，尤其是在涉及气化颅底骨的手术操作中。
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