| 姜海洋 李强 梁强 丁永忠 周旺宁.经鼻内镜手术进展[J].,2014,14(32):8391-6394 |
| 经鼻内镜手术进展 |
| The Evolution of Endoscopic Endonasal Surgery |
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| DOI： |
| 中文关键词: 经鼻 内镜 手术 |
| 英文关键词: Endoscopic Endonasal Surgery |
| 基金项目:中国抗癌协会神经肿瘤专业委员会（基于1p/19q、MGMT和TopoⅡa检测的脑胶质瘤个体化治疗研究） |
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| 中文摘要: |
| 颅底手术正随着经鼻内镜手术的发展而发生着转变。经鼻内镜手术最初开发于鼻窦手术，但其适应症已逐渐扩大到其它领
域，可以用于治疗大量的疾病。经鼻内镜手术的主要优点是：它利用天然的孔道来处理大量的颅内、鼻窦病变，避免了皮肤切口、
面部骨瓣切口、脑回缩等直接开颅所不可避免的后遗症。与传统的神经外科手术相比，发病率和死亡率下降，并间接减少了住院
时间和管理成本。本文就经鼻内镜手术的进展进行综述。在综述中阐述了经鼻内镜手术的适应症和基本原则，以及显露、特别是
重建技术的进展，这些进展要求在可接受的并发症前提下达到更广泛的切除；讨论了经鼻内镜手术的局限性，尤其是，虽然这种
手术往往是“微创”，但它并不是完全没有并发症；展望了经鼻内镜手术的适应症会不断拓宽，并发症会越来越少的美好未来。 |
| 英文摘要: |
| Skull base surgery has been transformed by the development of endoscopic techniques. Endoscopic procedures were
first used for pituitary surgery and were then gradually extended to other regions. A wide range of diseases are now accessible to
endoscopic skull base surgery. The major advantage of the endoscopic endonasal approach is that it provides direct anatomical access to a
large number of intracranial and paranasal sinus lesions, avoiding the sequelae of a skin incision, facial bone flap or craniotomy, and
brain retraction, which is inevitable with conventional neurosurgical incisions, resulting in decreased morbidity and mortality and,
indirectly, decreased length of hospital stay and management costs. This paper provides a review of endoscopic skull base surgery. The
indications and general principles of endoscopic endonasal skull base surgery are described. Progress in exposure and especially
reconstruction techniques is described. This progress now allows more extensive resections, while maintaining acceptable morbidity. The
limits of this surgery are also discussed; in particular, although this surgery is often described as "minimally invasive", it is not completely
devoid of morbidity. But the indications of endoscopic endonasal surgery will be broadened, and the complications will be reduced. |
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