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首页> 外文期刊>Journal of clinical neuroscience: official journal of the Neurosurgical Society of Australasia >The modified hemi-Lothrop procedure: A variation of the endoscopic endonasal approach for resection of a supraorbital psammomatoid ossifying fibroma
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The modified hemi-Lothrop procedure: A variation of the endoscopic endonasal approach for resection of a supraorbital psammomatoid ossifying fibroma

机译：改良的半-Lothrop手术：鼻内镜鼻内入路手术切除眶上类房颤骨化性纤维瘤

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摘要

Tumors in the supraorbital region are most commonly accessed through transcranial approaches, including fronto-orbital, orbitozygomatic, and eyebrow supraorbital keyhole approaches. Purely endoscopic endonasal approaches (EEA) are more challenging to perform because of limitations in access and visualization for lateral extension beyond the midline corridor. The modified hemi-Lothrop procedure, a variation of an extended EEA, allows for binostril access and visualization of the lateral supraorbital region while preserving the contralateral frontal sinus drainage pathway. The operative technique and nuances are illustrated in a rare case of a supraorbital juvenile psammomatoid ossifying fibroma (JPOF) causing symptomatic orbital compression. The key components of the approach consisted of an endoscopic Draf IIB (left frontal sinusotomy) ipsilateral to the tumor, and a superior septectomy for binostril bimanual instrumentation. Excellent visualization, access, and tumor removal of the supraorbital region was achieved with angled endoscopy and curved instrumentation from the contralateral nasal cavity and through the septectomy window ("cross-court" trajectory). The modified hemi-Lothrop procedure with angled endoscopy is a safe and effective alternative route to traditional transcranial approaches to access the supraorbital region. To our knowledge, this is the first case of a supraorbital JPOF that was successfully resected via a purely EEA. (C) 2014 Elsevier Ltd. All rights reserved.
机译：眶上区域的肿瘤最常通过经颅途径进入，包括额眶，眶y和眉眼眶上匙孔入路。由于内窥镜超出中线走道的侧向伸入和可视化方面的限制，纯内窥镜鼻腔入路（EEA）的执行更具挑战性。改良的半-Lothrop手术是扩展的EEA的一种变体，可在保持对侧额窦窦引流途径的同时，使比诺斯通进入并眼眶上眶区可视化。在罕见的眶上型青少年类房颤骨化性纤维瘤（JPOF）引起症状性眼眶压迫的情况下，说明了手术技术和细微差别。该方法的关键组成部分包括与肿瘤同侧的内窥镜Draf IIB（左额窦正位切开术）和用于双炔诺酮双手器械的上位鼻中隔切除术。通过对侧鼻腔和鼻中隔切除术窗口（“跨法院”轨迹）进行倾斜的内窥镜检查和弯曲器械，可以实现眶上区域的出色可视化，通路和肿瘤切除。改良的带角度内窥镜检查的半-Lothrop手术是进入经眶上区域的传统经颅入路的安全有效替代途径。据我们所知，这是眶上JPOF的首例病例，该病例成功通过纯EEA切除。 （C）2014 Elsevier Ltd.保留所有权利。

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