内镜经上颌窦入路切除侧颅底肿瘤  

Endoscopic transmaxillary approach in resection of lateral skull base tumor

作　　者：柏瑞[1] 李学记[1] 

机构地区：[1]国家癌症中心/中国医学科学院北京协和医学院肿瘤医院神经外科,100021

出　　处：《肿瘤研究与临床》2017年第4期284-288,共5页Cancer Research and Clinic

基　　金：北京市科学技术委员会首都临床特色应用研究专项项目（Z161100000516118）

摘　　要：侧颅底肿瘤手术切除是颅底外科的重点和难点，经历了从肉眼巨创到显微手术至全内镜微创手术的艰难蜕变。内镜技术以全景视野、创伤小但手术涵盖范围广等特点为侧颅底肿瘤的手术治疗开辟了全新视角。侧颅底肿瘤内镜手术入路均可归纳为内镜经上颌窦入路，只是根据开放上颌窦径路、方式不同分为经鼻上颌窦入路、经唇下上颌窦前壁入路以及联合入路，而前者又可细分为经同侧鼻腔入路、经泪前隐窝入路、经对侧鼻腔-鼻中隔入路、经鼻Denker入路四种。文章在综述各种内镜经上颌窦入路的历史演变、解剖研究及临床探索的基础上，比较分析各种入路的优缺点，以期为侧颅底肿瘤手术方法的个性化选择提供参考。The resection of lateral skull base tumour has always been a crucial and difficult aspect of skull base surgery. Its operation development has experienced several evolutionary phases, including unaided eye-surgery which could result in huge trauma, microsurgery and completely endoscopic surgery. At present, the endoscopic technique known for its panoramic visibility, minimal invasion and extensive scope of operation, has opened up a brand new perspective for the lateral skull base tumour surgery. Currently, the approach of lateral skull base tumour endoscopic surgery can be generalized as endoscopic transmaxillary approach （ETA）. And based on different pathways and methods to expose the maxillary sinus, ETAs can be divided into three, endonasal transmaxillary approach（ENTA）, endoscopic sublabial transmaxillary approach （ESTA） and combined approach, while ENTA includes ipsilateral endonasal transmaxillary approach （IENTA）, prelacrimal recess approach （PRA）, contralateral endonasal transseptal approach （CENTA） and transnasal Denker approach. In this paper, on the basis of the summarization of ETAs related historical evolution, anatomical studys and clinical researches, the merit and demerit of all sorts of ETAs are compared and analyzed. We hope this review could act as a reference for selecting the personalized endoscopic surgery approach of lateral skull base tumour.

关 键 词：颅底肿瘤 上颌窦 内窥镜检查 

分 类 号：R739.41[医药卫生—肿瘤]