经鼻内镜颅底外科

目的探讨经鼻窦内镜开展颅底区域微创外科手术的可行性.方法开展经鼻窦内镜颅底外科手术72例.结果12例脑脊液鼻漏修补术均一次获得成功;13例接受视神经管减压术,8例于术后11日～一个月患侧恢复视力、眼前指数或光感,余5例术后无明显改善;5例蝶鞍充填术的患者术后头痛症状消失,33例垂体瘤、2例鞍区颅咽管瘤、5例筛窦癌和1例造釉细胞瘤均获得完全切除;1例侵袭性垂体腺瘤大部切除.除视神经管减压术中有1例并发颈内动脉破裂(抢救成功)外,其他病例无严重并发症.结论经鼻窦内镜颅底外科手术简便、微创、安全、有效.是一项值得临床应用的新技术,但必须严格掌握好此类手术的适应证.

Transnasal endoscopic surgery of skull base

Objective To recognize the indications and the value of transnasal endoscopic surgery of skull base. Methods Using endoscopic transnasal approaches surgery technique to the management of 72 cases of beign and malignant lesions of skull base since 1996, emphasizing general principles for management and specific details for individual lesions including cerebrospinal fluid rhinorrhea repair, optic nerve decompression, obliteration of empty sella, pituitary tumor and intrasella tumor resection, and malignant tumor resection. Results Endoscopic transnasal approach were used successfully in all the cases. Conclusions The minimally invasive technique is a safe, valuable and efficient procedure for management of some lesions of skull base.