Magnan J, Chays A, Caces F, Lepetre C, Cohen J M, Belus J F, Bruzzo M
Service ORL, Unité d'Oto-Neuro-Chirurgie, Hôpital Nord, Marseille.
Ann Otolaryngol Chir Cervicofac. 1993;110(5):259-65.
An endoscopic approach to the cerebellopontine angle has been suggested by several authors over the last 20 years but it is only recently that the technical and operative conditions for successful endoscopy could be met. The retrosigmoid approach provides simple and direct access to the cerebellopontine zone. The endoscope, with its distal light source, provides excellent illumination of a wide visual field within an anatomical site particularly rich in neurovascular structures. Endoscopic and microsurgical techniques may be combined for the surgical management of acoustic neuroma with the advantage of assuring better exposure of structures adjacent to the tumor and better control of the quality of dissection of the fundus of the internal auditory canal. The addition of endoscopic techniques, during surgery for trigeminal neuralgia or unilateral facial spasm, makes it possible to accurately locate the site of neurovascular compression without either retraction of the cerebellum or unnecessary dissection.
在过去20年里，有几位作者提出了经内镜进入桥小脑角的方法，但直到最近才具备成功进行内镜检查的技术和手术条件。乙状窦后入路可简单、直接地进入桥小脑区。带有远端光源的内镜能在一个神经血管结构特别丰富的解剖部位提供广阔视野的极佳照明。内镜技术和显微外科技术可联合用于听神经瘤的手术治疗，其优点是能更好地暴露肿瘤邻近结构，并更好地控制内耳道底部的解剖质量。在三叉神经痛或单侧面肌痉挛的手术中增加内镜技术，可在不牵拉小脑或进行不必要解剖的情况下准确确定神经血管压迫部位。
