内镜辅助眶上锁孔入路显微手术治疗前循环动脉瘤

Neuroendoscope-assisted Microsurgery through Superaorbital Keyhole Approach for Intracranial Aneurysm of Anterior Circulations

目的探讨内镜辅助眶上锁孔入路显微手术治疗前循环动脉瘤的临床效果及可能存在的风险与对策。方法对28例前循环动脉瘤病人经眶上锁孔入路在显微镜引导下置入内镜观察动脉瘤颈与周围结构的局部解剖关系,辅助分离瘤颈与周边的粘连,夹闭瘤颈,此后再次用内镜观察了解夹闭情况。结果28例动脉瘤均成功准确夹闭,27例恢复良好,1例中残。结论内镜辅助眶上锁孔入路手术可明显增加动脉瘤及周围结构的可视范围,减少对脑组织的牵拉或无效脑暴露,创伤小,减少和避免了重要结构的损伤,并发症少,提高了动脉瘤的手术夹闭率。

Objective To explore the clinical effect of neuroendoscope-assisted microsurgery through superaorbital keyhole approach on intracranial aneurysms of anterior circulations and its safety. Methods The intracranial anenrysms of anterior circulations were clipped by neuroendoscope-assisted microsurgery through superaorbital keyhole approach in 28 patients. The relationship of the aneurysms and the tissues surrounding them were intraoperatively observed. Results All the aneurysms were accurately clipped in 28 patients. Of 28 patients, 27 were recovered well and 1 was moderately disabled. Conclusions The neuroendoscope-assisted microsurgery through superaorbital keyhole approach can expand visual field, reduce the lesion induced by the operation and is a valuable technique to treat the aneurysms of anterior circulations.