内镜颅底外科的发展
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摘要
内镜颅底外科起步于20世纪90年代,近20年迅速发展,范围涉及自前颅底至颅颈交界区和颈静脉孔区的各个颅底区域,包括某些颅内外沟通性病变和硬膜内病变,使颅底肿瘤全切除率和颅底重建成功率进一步提高。同时,"双人四手"操作和低温等离子刀技术的应用使内镜手术处理复杂颅底病变成为可能;手术导航系统的应用也有助于安全、彻底清除颅底病变。
Endoscopic skull base surgery started from 1990 s, and has undergone fast development in the past 20 years. It has involved various skull base regions from the anterior skull base to the craniovertebral junction(CVJ) and jugular foramen, including intra-and extra-cranial communicating lesions and intradural lesions, and further improved total section rate of skull base neoplasms and success rate of skull base reconstruction. At the moment, the improvement in surgical techniques, like "two-surgeon, fourhand" technique and use of radiofrequency coblation has rendered endoscopic procedures capable of managing complex pathologies. Intraoperative neuronavigation systems contribute to safe and complete removal of skull base tumors.
Endoscopic skull base surgery started from 1990 s, and has undergone fast development in the past 20 years. It has involved various skull base regions from the anterior skull base to the craniovertebral junction(CVJ) and jugular foramen, including intra-and extra-cranial communicating lesions and intradural lesions, and further improved total section rate of skull base neoplasms and success rate of skull base reconstruction. At the moment, the improvement in surgical techniques, like "two-surgeon, fourhand" technique and use of radiofrequency coblation has rendered endoscopic procedures capable of managing complex pathologies. Intraoperative neuronavigation systems contribute to safe and complete removal of skull base tumors.
引文
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[8]Zhang QH,Lv H,Chen G,Guo H.Endoscopic endonasal removal of pituitary adenomas with paraclival internal carotid artery invasion[J].ORL J Otorhinolaryngol Relat Spec,2010,72:28-37.
[9]Jho HD,Ha HG.Endoscopic endonasal skull base surgery.Part1:the middle anterior fossa skull base[J].Minim Invasive Neurosurg,2004,47:1-8.
[10]Cook SW,Smith Z,Kelly DF.Endonasal transsphenoidal removal of tuberculum sellae meningiomas:technical note[J].Neurosurgery,2004,55:239-246.
[11]Batra PS,Citardi MJ,Worley S,Lee J,Lanza DC.Resection of anteriorskull base tumors:comparison of combined traditional and endoscopic techniques[J].Am J Rhinol,2005,19:521-528.
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[13]Zhang QH,Yan B,Li CQ,LüHL,Kong F.Endoscopic transnasal reconstruction of skull base defects with titanium mesh[J].Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi,2007,42:324-327.[张秋航,严波,李长青,吕海丽,孔锋.内镜经鼻入路前颅底重建[J].中华耳鼻咽喉头颈外科杂志,2007,1442:324-327.]
[14]Zhang QH,Feng YJ,Kong F,Chen G,Guo HC.Clinical observation of non-osseous reconstruction for bony defects of anterior cranial fossa[J].Zhongguo Wei Qin Xi Shen Jing Wai Ke Za Zhi,2010,15:388-391.[张秋航,冯燕军,孔锋,陈革,郭宏川.颅前窝底骨质缺损无骨性重建的临床观察[J].中国微侵袭神经外科杂志,2010,15:388-391.]
[15]Zhang Q,Wang Z,Guo H,Kong F,Chen G,Bao Y,Ling F.Resection of anterior cranial base meningiomas with intra-and extracranial involvement via a purely endoscopic endonasal approach[J].ORL J Otorhinolaryngol Relat Spec,2012,74:199-207.
[16]Hu YH,Lu TX,Mai WY,Han F,Huang Y,Liu H,Zhang EP.Important prognostic factors in patients with skull base erosion from nasopharyngeal carcinoma after radiotherapy[J].Zhonghua Er Bi Yan Hou Ke Za Zhi,2001,36:463-467.[胡永红,卢泰祥,麦伟源,韩非,黄莹,刘慧,张恩罴.鼻咽癌颅底骨质破坏放射治疗后预后因素分析[J].中华耳鼻咽喉科杂志,2001,36:463-467.]
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[18]Jho HD,Ha HG.Endoscopic endonasal skull base surgery.Part3:the clivus and posterior fossa[J].Minim Invasive Neurosurg,2004,47:16-23.
[19]Zhang QH,Kong F,Yan B,Ni ZL.Endoscopic endonasal surgery for clival chordoma and chordosarcoma[J].Zhongguo Wei Qin Xi Shen Jing Wai Ke Za Zhi,2006,11:438-440.[张秋航,孔锋,严波,倪志立.经鼻内镜斜坡脊索瘤和脊索肉瘤的外科治疗[J].中国微侵袭神经外科杂志,2006,11:438-440.]
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[21]Alfieri A,Jho HD,Schettino R,Tschabitscher M.Endoscopic endonasal approach to the pterygopalatine fossa:anatomic study[J].Neurosurgery,2003,52:374-380.
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