McDermott M W, Rootman J, Durity F A
Department of Neurological Surgery, School of Medicine, University of California, San Francisco, USA.
Neurosurgery. 1995 Jun;36(6):1215-8; discussion 1218-9. doi: 10.1227/00006123-199506000-00027.
Removal of meningiomas from the region of the cribriform plate and the planum sphenoidale may entail a bifrontal craniotomy and an interruption of the tumor's blood supply along the floor of the anterior cranial base. However, with this approach, the presence of bulky tumor above makes it difficult to control bleeding from multiple bony foramina in the anterior cranial base and to expose these foramina. The blood supply to the dura in this region, and, therefore, to these tumors, is predominantly from the anterior and posterior ethmoid arteries. Preoperative embolization of ethmoid arteries is not without a significant and prohibitive risk of blindness. A frontoethmoidal approach to the arteries on both sides requires two separate skin incisions. Therefore, a subperiosteal, subperiorbital dissection and division of these arteries via a bicoronal skin incision is a practical alternative.
从筛板和蝶骨平台区域切除脑膜瘤可能需要进行双额开颅手术，并中断肿瘤沿前颅底底部的血液供应。然而，采用这种方法时，上方存在巨大肿瘤会使控制来自前颅底多个骨孔的出血以及暴露这些骨孔变得困难。该区域硬脑膜的血液供应，以及因此这些肿瘤的血液供应，主要来自筛前动脉和筛后动脉。术前对筛动脉进行栓塞并非没有导致失明的重大且难以承受的风险。双侧动脉的额筛入路需要两个单独的皮肤切口。因此，通过双冠状皮肤切口进行骨膜下、眶下解剖并切断这些动脉是一种可行的替代方法。
