Expanding horizons: the feasibility and challenges of tubular retraction in endoscopic transorbital skull base approaches.

IF 1.4 4区 医学 Q2 Medicine
Gardashkhan Karımzada, Demet Evleksiz Karımzada, Gökberk Erol, Emrah Celtikci, Nail Çağlar Temiz, Ahmet Murat Kutlay, Yusuf İzci, Walter C Jean, Abuzer Güngör
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引用次数: 0

Abstract

Purpose: Endoscopic transorbital skull base approaches are always challenging and require good anatomical knowledge.The aim of this study was to describe the anatomical pathways of endoscopic transorbital approaches and to determine the limitations of these procedures. To evaluate the feasibility of the tubular retractor and the difference with manual retractor.

Methods: The targets of endoscopic transorbital approach were the anterior and middle cranial fossa, mesial temporal region, meckel's cave, petroclival area, opticocarotid region, anterior and lateral walls of the cavernous sinus, etc. Step-by-step anatomical dissections were performed in cadaveric heads using manual and tubular retractors.

Results: Anterior and middle cranial fossa was reached. The branches of the trigeminal nerve, the lateral wall of the cavernous sinus, meckel's cave and gasserian ganglion were exposed by manual and tubular retraction using an endoscopic transorbital approach. Access to the temporal horn of the lateral ventricle and the mesial temporal region was more accessible with a tubular retractor. Also, following the anterior clinoidectomy, the cavernous segment of the internal carotid artery, as well as, the arteries of the anterior circulation were exposed to gain access the vascular skull base lesions.

Conclusion: The endoscopic transorbital approach is suitable for the surgical treatment of many pathologies located in the anterior and middle skull base. It provides direct access to vascular and tumoral lesions. We observed that mesial temporal region interventions are possible with this approach. The transtubular technique may have some limitations, but in selected cases it can provide clear vision without brain retraction.

扩大视野:内窥镜下经眶颅底入路管状内收的可行性和挑战。
目的:内镜下经眶颅底入路具有挑战性,需要良好的解剖学知识。本研究的目的是描述内窥镜经眶入路的解剖路径,并确定这些手术的局限性。评价管状牵开器的可行性及与手动牵开器的区别。方法:内镜下经眶入路的目标为颅前中窝、颞内区、梅克尔洞、岩斜坡区、颈光区、海绵窦前侧壁等。一步一步解剖解剖在尸体头部进行使用手动和管状牵开器。结果:到达前、中颅窝。三叉神经分支、海绵窦侧壁、meckel's穴和gasserian神经节经鼻内镜经眶入路手工和管状后缩显露。使用管状牵开器更容易进入侧脑室颞角和颞内侧区。此外,在前斜突切除术后,暴露颈内动脉海绵状段,以及前循环动脉,以进入血管性颅底病变。结论:经鼻内窥镜眶内入路适用于许多颅底前、中部病变的手术治疗。它提供了直接进入血管和肿瘤病变的途径。我们观察到内侧颞区干预是可能的这种方法。经短突技术可能有一定的局限性,但在某些情况下,它可以提供清晰的视力而不需要大脑收缩。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Surgical and Radiologic Anatomy
Surgical and Radiologic Anatomy Medicine-Pathology and Forensic Medicine
CiteScore
2.40
自引率
14.30%
发文量
0
期刊介绍: Anatomy is a morphological science which cannot fail to interest the clinician. The practical application of anatomical research to clinical problems necessitates special adaptation and selectivity in choosing from numerous international works. Although there is a tendency to believe that meaningful advances in anatomy are unlikely, constant revision is necessary. Surgical and Radiologic Anatomy, the first international journal of Clinical anatomy has been created in this spirit. Its goal is to serve clinicians, regardless of speciality-physicians, surgeons, radiologists or other specialists-as an indispensable aid with which they can improve their knowledge of anatomy. Each issue includes: Original papers, review articles, articles on the anatomical bases of medical, surgical and radiological techniques, articles of normal radiologic anatomy, brief reviews of anatomical publications of clinical interest. Particular attention is given to high quality illustrations, which are indispensable for a better understanding of anatomical problems. Surgical and Radiologic Anatomy is a journal written by anatomists for clinicians with a special interest in anatomy.
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