侧颅底外科纵览

 临床上,侧颅底可分为硬膜内桥小脑角区和硬膜外颞和颞下窝二个区。硬膜内区耳科入路摘除听神经瘤和硬膜外区颞下窝入路摘除颈静脉球瘤是现代侧颅底外科形成的主要源起。上述二条手术入路是由耳科医师开拓的,从而扩展了耳外科的领域,并分别介入了神经外科、头颈外科与再造外科等多门相关学科,成为多交叉学科的可持续发展的学术平台。侧颅底外科靠显微技术和手术入路创新得以在耳科建立。侧颅底外科有效治疗了颅底所谓高危不可达区的疾病。由于手术的复杂性和存在一定的风险,目前仍要求在每次治疗决策中,要在颅底结构和功能牺牲与生命安全二者之间寻找最佳的平衡。颅底疾病精准医疗或微创技术是未来研究的重要方面。

The survey of lateral skull base surgery

In clinics,lateral skull base comprises intradural cerebellopontine angle area,and the region of extradural temporal and infratemporal fossa.The modern lateral skull base surgery started from those two operations that were surgical removal of acoustic schwannoma via otological approach and the extirpation of glomus jugulare tumor through infratemporal fossa.The pioneers of these two classic surgeries were the otologists who developed the new field of otological surgery.Since then,the lateral skull base surgery has become a developed and academical platform of multiple related disciplines,such as neurosurgery,head neck surgery and reconstructive surgery etc.The lateral skull base surgeries build upon the microsurgical techniques and innovative surgical approaches,which are available successfully to treat riskful disorders in the so called inaccessible regions.Nevertheless,it is better to find the best equation between the preservation of skull base structures with their function and the vital safety during each decision of surgical strategy.Probably,minimal invasive surgery or precision treatments of the disorders in skull base would become a new horizon in the future.