神经内镜经鼻手术简史及多层颅底重建技术现状  

Overview of the history of endoscopic endonasal surgery and multilayer skull base reconstruction

作　　者：展如才[1,2] 王东海[1] 王新宇[1] 李新钢[1] 

机构地区：[1]山东大学齐鲁医院神经外科,山东济南250012 [2]济南市第三人民医院神经外科,山东济南250101

出　　处：《山东大学学报（医学版）》2014年第11期1-5,15,共6页Journal of Shandong University:Health Sciences

基　　金：国家自然科学基金(81172404;81372720)

摘　　要：20年来,随着医学科技及相关学科技术的发展,经鼻经蝶内镜手术以戏剧般的速度发展,并达到了一个新水平。与传统的经鼻蝶手术比较,内镜经鼻蝶手术是一个概念性的革新,它有许多无可比拟的优点,如更接近手术目标,避免对脑组织的牵拉和损伤,减少术后疼痛,恢复快,并发症少等。95%的鞍区病变都可以通过常规的经蝶内镜入路手术切除。近年来,内镜手术的适应证已经扩大到了整个颅底中线区的病变,即前到额窦,后达齿状突区域,以前认为通过内镜手术不可能切除这个区域的肿瘤和其他病变,现在都有可能通过扩大的内镜经鼻入路得到切除。同时,颅底重建技术的发展,使得脑脊液漏这个一直困扰着神经外科医生的难题得到了有效的解决。文章还讨论了内镜经鼻手术发展史上几位杰出的先驱和几项关键的技术创新。In the past 20 years,with advancement of science and technology,endoscopic endonasal transsphenoidal sur-gery has developed at a dramatic speed and reached a new level.Compared to conventional transnasal transsphenoidal approach,endoscopic transsphenoidal surgery is a conceptual revolution,which can be closer to the surgical target, avoid brain manipulation and retraction,create less postoperative pain,provide quicker recovery,and cause fewer com-plications.Up to 95% of lesions in the sellar area can be treated by routine endoscopic approach.More recently,the indications of endoscopic transsphenoidal approach include lesions of the whole medline skull base,namely from the fron-tal sinuses to the odontoid,and tumors previously supposed to be inaccessible through an endoscopic endonasal approach have been successfully removed through the extended approach.Technological innovation on reconstruction of skull base has effectively solved CSF leaks,which has bothered surgeons since original implement of the approach.This paper reviewed some key persons and technological innovations in the evolution of endoscopic transnasal skull base surgery.

关 键 词：神经外科历史 内镜经鼻入路 颅底 多层 重建 

分 类 号：R651.1[医药卫生—外科学]