内镜下扩大经鼻蝶入路术中多层技术颅底重建

Skull base multilevel-reconstruction in neuroendoscopic surgery via extended endoscopic endonasal transsphenoidal approach

目的总结内镜下扩大经鼻蝶入路鞍区及鞍旁区多层技术重建颅底的经验。方法回顾性分析12例鞍区及鞍旁区肿瘤的临床资料,其中颅咽管瘤4例,鞍区脑膜瘤3例,巨大垂体腺瘤5例;均行内镜下扩大经鼻蝶入路肿瘤切除术,并采用多层技术进行颅底重建。结果所有病例肿瘤均达全切除,颅底重建均1次修补成功。术后部分临床症状明显改善。随访3～6个月,均未出现脑脊液漏、细菌性脑膜炎和张力性气颅等并发症。结论内镜下扩大经鼻蝶入路术中多层技术重建颅底是一种简单、安全、有效的方法。

Objective To summarize the experience in reconstructing the skull base in the sellar and parasellar regions via extended endoscopic endonasal transsphenoidal approach.Methods Clinical data of 12 patients with sellar and parasellar tumors were analyzed retrospectively,including 4 craniopharyngiomas,3 sellar meningiomas and 5 pituitary macroadenomas.Multilayer technique was used to repair the defect following the tumor removal via extended endoscopic endonasal transsphenoidal approach.Results Total removal of the tumor was achieved in all the cases,and all the skull base defects were repaired successfully during a single surgical session.The follow-up period was 3 to 6 months,and there were no such complications as cerebrospinal leak,bacterial meningitis,and tension pneumoencephalos.Conclusions The method for skull base multilevel reconstruction in neuroendoscopic surgery via extended endoscopic endonasal transsphenoidal approach is simple,safe and effective.