内镜鼻颅底外科在神经外科发展中的现状和展望

The present situation and expectation of endoscopic endonasal skull base surgery in the development of neurosurgery

颅底外科手术难度大,风险高。内镜鼻颅底外科技术不断进步,手术领域日益拓展,发展前景令人瞩目。目前限制内镜鼻颅底外科在神经外科发展的主要因素是神经外科术者鼻颅底内镜学习曲线较长,术后脑脊液漏和颅神经功能损害等手术并发症。因此,加强内镜操作训练,熟悉鼻颅底内镜解剖,重视颅底重建和术中神经电生理监测,减少术后脑脊液漏和颅神经功能损害发生率,强调多学科合作治疗颅底肿瘤都是进一步安全有效发展内镜鼻颅底外科的重要措施。

Skull base surgery is considered the most challenging and risky. The surgical skills of endoscopic endonasal skull base surgery are making unceasing progress, the surgical field is expanding continually, and the prospect for further development is quite remarkable. For now, the main constraining factors for the development of endoscopic endonasal skull base surgery in neurosargery are the relatively long /earning curve and the postoperative complications, including cerebrospinal fluid leakage and cranial nerve function damage. Therefore, reinforcing the endoscopic surgical training, being familiar with the endoscopic anatomy of the skull base, paying attention to the reconstruction of the skull base and the intraoperative neurophysiological monitoring, reducing the incidence of postoperative cerebrospinal fluid leakage and cranial nerve function damage, and stressing the importance of muhidisciplinary cooperation in the treatment of cranial base tumors are all important measures for the further safe and effective development of endoscopic endonasal skull base surgery.