经鼻内窥镜手术在颅底外科的应用

Transnasal endoscopic surgery of skull base

为探讨经鼻内窥镜行颅底手术的可行性，笔者开展了经易内窥镜颅底外科手术54例。结果显示：10例脑脊液鼻漏修补术均一次获得成功；11例接受视神经管减压术，6例于术后11d～1个月伤侧恢复光感和眼前指数，余5例术后无明显改善；3例蝶鞍充填术的患者术后者痛症状消失；17例垂体瘤、3例筛窦癌、8例鼻咽癌和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。无严重并发症发生。提示：经鼻内窥镜颅底手术简便、安全、有效，是一项临床可以开展与应用的外科技术，但须掌握好此类手术的适应证。

This article will discuss our experience in managing 54 cases of benign and malignant lesions of skull base using endoscopic transnasal approaches surgery technique since 1991, 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 resection, and malignant tumor resection. In the result, endoscopic transnasal approach were used successfully in all the cases, it indicates that the new technique is a safe, valuable and efficient procedure for management of some lesions of skull base.