神经内镜技术在神经眼科诊疗领域的应用  

Endoscopy neurosurgery for diagnosis and treatment of neuro-ophthalmologic disorders

作　　者：张学军 田国红 ZHANG Xuejun;TIAN Guohong(Department of Neurosurgery,Shanghai Donglei Brain Hospital,201700 Shanghai,China;Department of Ophthalmology,Eye&ENT Hospital,Fudan University,NHC Key laboratory of Myopia and Related Eye Diseases,Shanghai Key Laboratory of Visual Impairment and Restoration,Shanghai 200031,China)

机构地区：[1]上海冬雷脑科医院神经外科,上海201700 [2]复旦大学附属眼耳鼻喉科医院眼科国家卫生健康委员会近视眼及相关眼病重点实验室、上海市视觉损害与重建重点实验室,上海200031

出　　处：《中国眼耳鼻喉科杂志》2024年第5期368-372,共5页Chinese Journal of Ophthalmology and Otorhinolaryngology

基　　金：国家重点研发计划“干细胞及转化研究”重点专项(2020YFA0112700)。

摘　　要：神经内镜技术主要包括鼻内镜神经外科、脑室镜外科、颅内镜锁孔外科及内镜通道外科等,其中鼻内镜目前已广泛用于鞍区肿瘤的微创切除治疗。由于神经眼科领域涉及视路病变导致的传入障碍性疾病(表现为视力下降和/或视野缺损)及传出障碍性疾病(表现为复视和/或眼肌麻痹)其病变部位多位于视神经管、眶尖、海绵窦、颅底等解剖结构错综复杂、邻近血管神经丰富的部位,常规开颅手术不但创伤大,且容易导致严重并发症。随着神经内镜技术在神经眼科领域应用的普及,在视神经管减压、鞍区/颅底肿瘤切除、海绵窦病变活检以及第三脑室底部造瘘等手术中均降低了风险,并得以广泛开展。本文在综合国内外文献的基础上,结合复旦大学附属眼耳鼻喉科医院神经眼科中心近年来的多学科间诊疗心得,对神经内镜技术在神经眼科疾病诊疗领域的作用进行了总结。Neuro-endoscopy techniques mainly include endoscopic transnasal skull base surgery,endoscopic ventricular surgery,endoscopic transcranial keyhole surgery and endoport surgery et al.Among them,endoscopic transnasal skull base surgery has been wildly utilized for removing tumors localized in sellar region.Due to the neuro-ophthalmologic disorders involving the visual afferent system(presented with visual loss and/visual field defect)and efferent system(presented with diplopia/ophthalmoplegia),the location of optic canal,orbital apex,cavernous sinus,skull base are usually involved,in which the neuro-anatomy are complicated and blood vessels are abundant.The routine craniotomy surgery usually leads to serious complications and trauma.With the utilizing of neuro-endoscopy methods,optic nerve decompression,sellar and skull base tumor removal,cavernous sinus biopsy and third ventriculostomy are widely promoted due to its minimal side effects.In this article,we reviewed the update literatures and summarized the multidisciplinary study result of neuro-ophthalmologic division in Eye Ear Nose and Throat Hospital of Shanghai in recent years.

关 键 词：神经内镜 神经眼科 神经外科 鞍区 海绵窦 视神经 

分 类 号：R774[医药卫生—眼科]