摘要:The skull base surgery includes excision, restoration and modification of skull base conditions, which consist of trauma,tumors,vascular lesions, congenital abnormalities,and inflammatory focus originating from or involved in skull base. It involves multidisciplinary knowledge including neurosurgery, ophthalmology, orthopedics, otolaryngology and maxillofacial surgery etc. and need assistance and participation of various modern technologies including neuro-monitoring, neuro-navigation and neuro-intervention etc. Because of its deep location, complex anatomical relationships and many important tissues involved ,skull base had been considered insurmountable area of surgery before 1960s. Since the onset of skull base surgery in 1960s, it has developed and strengthened step by step. Now it has step into the era of minimally invasive skull base surgery after the development of two stages of naked eye skull base surgery and microscopic skull base surgery. Its concept is to decrease the damage of normal tissues and completely treat the lesions as far as possible simultaneously by making full use of modern scientific methods and the consummate skills of the operator. One of its characteristics is utilizing the natural intervals to expose the lesions. And the neuroendoscopy can provide a closer look, wide field of vision and a distinct image, so it is fully suitable for the need of modern skull base surgery. After Jankowski treated the pituitary adenomas by endoscopic trans-nasal-sphenoidal approach for the first time in 1992,the endoscopic skull base surgery is gradually becoming mature. With the development of neurosurgical technologies including neuro-monitoring, neuro-navigation and neuro-imaging etc. and the improvement of new apparatus including high speed burrs, laser, microCUSA and holding arms etc., the quality of endoscopic skull base surgery has obtained further improvement. Its advantages include more thorough tumor resection, fewer surgical complications and reductions in operative and hospitalization time. In this paper, we will summarize the advancement of endoscopic skull base surgery in translational medicine.
[1] Jankowski R, Auque J, Simon C, et al. Endoscopic pituitary tumor surgery. Laryngoscope. 1992,102(2):198-202.
[2] Zhang YZ, Zhang HW. Progress of endoscopic trans-nasal operation. Chin J Neurosurg, 2004,20(2): 105-108.
[3] Zhang YZ, Wang ZC, Liu YJ, Treatment of pituitary tumors via endoscopic endonasal transsphenoidal approach. Chin J Minim Invasive Neurosurg, 2007, 12(2): 51-54.
[4] Jho HD, Ha HG. Endoscopic endonasal skull base surgery: part1-the midline anterior fossa skull base. Minim Invasive Neurosurg, 2004, 47(1): 1-8.
[5] Cavallo, LM, Messina A, Cappabianca P, et al. Endoscopic endonasal surgery of the midline skull base: anatomical study and clinical considerations. Neurosurg Focus, 2005, 19 (1): E2.
[6] Kassam A, Snyderman CH, Mintz A, et al. Expanded endonasal approach: the rostrocaudal axis. Part I. Crista galli to the sella turcica. Neurosurg Focus, 2005; 19 (1): E3.
[7] Jho HD, Ha HG. Endoscopic endonasal skull base surgery: part 3-the clivus and posterior fossa. Minim Invasive Neurosurg, 2004, 47(1): 16-23.
[8] Solares CA, Fakhri S, Batra PS, et al. Transnasal endoscopic resection of lesions of the clivus: A preliminary report. Laryngoscope, 2005, 115(11): 1917-1922.
[9] Jho HD, Carrau RL, McLaughlin MR, et al. Endoscopic transsphenoidal resection of a large chordoma in the posterior fossa. Acta Neurochir(Wien), 1997, 139(4): 343-348.
[10] Kwoh Y, Hou J, Jonckheere EA, et al. A robot with improved absolute positioning accuracy for CT guided stereotactic brain surgery. IEEE Trans Biomed Eng, 1988,35(2):153 – 160.
[11] Ketcham AS, Hoye RC, Van Buren JM, et al. Complications of intracranial facial resections for tumors of the paranasal sinuses. Am J Surg, 1966, 112(4):591–596.
[12] Cappabianca P, Cavallo LM, de Divitiis E. Collagen sponge repair of small cerebrospinal fluid leaks obviates tissue grafts and cerebrospinal fluid diversion after pituitary surgery. Neurosurgery, 2002, 50(5):1173–1174.
[13] Cappabianca P, Cavallo LM, Esposito F, et al. Sellar repair in endoscopic endonasal transsphenoidal surgery: Results of 170 cases. Neurosurgery, 2002, 51(6):1365–1371.
[14] Kubota T, Hayashi M, Kabuto M, et al.Reconstruction of the skull base using a silicone plate during transsphenoidal surgery. Surg Neurol, 1991, 36(5):360–364.
[15] Moyer JS, Chepeha DB, Teknos TN. Contemporary skull base reconstruction. Curr Opin Otolaryngol Head Neck Surg, 2004, 12(4):294–299.
[16] Kassam AB, Thomas A, Carrau RL, et al. Endoscopic reconstruction of the cranial base using a pedicled nasoseptal flap. Neurosurgery, 2008 J63(1 Suppl 1):ONS44-52; discussion ONS52-3.
[17] Horiguchi K, Murai H, Hasegawa Y. Endoscopic endonasal skull base reconstruction using a nasal septal flap: surgical results and comparison with previous reconstructions. Neurosurg Rev, 2010, 33(2):235–241
[18] Hadad G, Bassagasteguy L, Carrau RL, et al. A novel reconstructive technique after endoscopic expanded endonasal approaches: vascular pedicle nasoseptal flap. Laryngoscope, 2006, 116(10):1882–1886.
Lan Xie,Yong Guo,Guo-liang Huang,Wan-li Xing,Hua-fang Gao,Ling-xiang Zhu,Dong Wang,Guan-bin Zhang,Yi-min Sun,Zhi-wei Zhang,Can Wang,Gao-shan Jing,Wen-yan Qin,Keith Mitchelson,Yu-xiang Zhou,Jing Cheng. Advances in translational medicine for individualized diagnosis of diseases[J]. Translational Medicine Research (Electronic Edition), 2011, 1(1): 46-68.