Endoscopic endonasal skull base surgery

被引:48
作者
Verillaud, B. [1 ]
Bresson, D. [2 ]
Sauvaget, E. [1 ]
Mandonnet, E. [2 ]
Georges, B. [2 ]
Kania, R. [1 ]
Herman, P. [1 ]
机构
[1] Univ Paris 07, Hop Lariboisiere, AP HP, Serv Otorhinolaryngol, F-75475 Paris 10, France
[2] Univ Paris 07, Hop Lariboisiere, AP HP, Serv Neurochirurg, F-75475 Paris 10, France
关键词
Endoscopic endonasal skull base surgery; Cerebrospinal fluid leak; PTERYGOPALATINE FOSSA; COMPUTED-TOMOGRAPHY; EXPANDED ENDONASAL; MALIGNANT-TUMORS; PETROUS APEX; CRANIAL BASE; RECONSTRUCTION; RESECTION; REPAIR; FLAP;
D O I
10.1016/j.anorl.2011.09.004
中图分类号
R76 [耳鼻咽喉科学];
学科分类号
100213 ;
摘要
Skull base surgery has been transformed by the development of endoscopic techniques. Endoscopic procedures were first used for pituitary surgery and were then gradually extended to other regions. A wide range of diseases are now accessible to endoscopic skull base surgery. The major advantage of the endoscopic endonasal approach is that it provides direct anatomical access to a large number of intracranial and paranasal sinus lesions, avoiding the sequelae of a skin incision, facial bone flap or craniotomy, and brain retraction, which is inevitable with conventional neurosurgical incisions, resulting in decreased morbidity and mortality and, indirectly, decreased length of hospital stay and management costs. Moreover, the increasing number of publications in this field illustrates the growing interest in these techniques. This paper provides a review of endoscopic skull base surgery. The indications and general principles of endoscopic endonasal skull base surgery are described. Progress in exposure and especially reconstruction techniques is described. This progress now allows more extensive resections, while maintaining acceptable morbidity. The limits of this surgery are also discussed; in particular, although this surgery is often described as "minimally invasive", it is not completely devoid of morbidity. (C) 2012 Elsevier Masson SAS. All rights reserved.
引用
收藏
页码:190 / 196
页数:7
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