...
  • 主题
高级搜索  >
历史搜索 清空历史
首页> 外文期刊>Acta Neurochirurgica >Safety of drilling for clinoidectomy and optic canal unroofing in anterior skull base surgery
【24h】

Safety of drilling for clinoidectomy and optic canal unroofing in anterior skull base surgery

机译：颅底前路手术中进行类盲窦切除术和视神经管根治术的钻孔安全性

获取原文
获取原文并翻译 | 示例
           
页面导航
  • 摘要
  • 著录项
  • 相似文献
  • 相关主题

摘要

Background: Skull base drilling is a necessary and important element of skull base surgery; however, drilling around vulnerable neurovascular structures has certain risks. We aimed to assess the frequency of complications related to drilling the anterior skull base in the area of the optic nerve (ON) and internal carotid artery (ICA), in a large series of patients. Methods: We included anterior skull base surgeries performed from 2000 to 2012 that demanded unroofing of the optic canal, with extra- or intradural clinoidectomy and/or drilling of the clinoidal process and lateral aspect of the tuberculum sella. Data was retrieved from a prospective database and supplementary retrospective file review. Our IRB waived the requirement for informed consent. The nature and location of pathology, clinical presentation, surgical techniques, surgical morbidity and mortality, pre- and postoperative vision, and neurological outcomes were reviewed. Results: There were 205 surgeries, including 22 procedures with bilateral optic canal unroofing (227 optic canals unroofed). There was no mortality, drilling-related vascular damage, or brain trauma. Complications possibly related to drilling included CSF leak (6 patients, 2.9 %), new ipsilateral blindness (3 patients, 1.5 %), visual deterioration (3 patients, 1.5 %), and transient oculomotor palsy (5 patients, 2.4 %). In all patients with new neuropathies, the optic and oculomotor nerves were manipulated during tumor removal; thus, new deficits could have resulted from drilling, or tumor dissection, or both. Conclusion: Drilling of the clinoid process and tuberculum sella, and optic canal unroofing are important surgical techniques, which may be performed relatively safely by a skilled neurosurgeon.
机译：背景：颅底钻孔术是颅底手术的必要和重要组成部分。但是，在脆弱的神经血管结构周围钻探有一定的风险。我们旨在评估在一系列患者中与在视神经（ON）和颈内动脉（ICA）区域钻前颅底有关的并发症的发生频率。方法：我们纳入了从2000年至2012年进行的前颅底手术，这些手术要求对视神经管进行隆起，硬膜外或硬膜内切除和/或钻探椎弓突和蝶鞍的外侧。从前瞻性数据库和补充回顾性文件审查中检索数据。我们的IRB放弃了知情同意的要求。回顾了病理学的性质和位置，临床表现，手术技术，手术发病率和死亡率，术前和术后的视力以及神经系统的预后。结果：共进行了205例手术，其中22例行双侧视神经管根治术（227视神经管未根治术）。没有死亡，与钻探有关的血管损伤或脑外伤。可能与钻孔有关的并发症包括脑脊液漏（6例，占2.9％），新患侧失明（3例，占1.5％），视力下降（3例，占1.5％）和短暂性动眼神经麻痹（5例，占2.4％）。在所有有新神经病的患者中，在切除肿瘤时都操纵了视神经和动眼神经。因此，可能是由于钻孔或肿瘤解剖或两者兼而有之造成的新缺陷。结论：对类固醇突和结节结核进行钻孔以及对视神经管进行屋顶固定是重要的手术技术，熟练的神经外科医生可以相对安全地进行手术。

著录项

相似文献

  • 外文文献
  • 中文文献
  • 专利
获取原文

客服邮箱：kefu@zhangqiaokeyan.com

京公网安备：11010802029741号 ICP备案号：京ICP备15016152号-6 六维联合信息科技 (北京) 有限公司©版权所有

  • 客服微信

  • 服务号