V Ricciuti, E Peppucci, A Montalbetti, G Piras, G Spena, C G Giussani, C Zoia
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引用次数: 0
摘要
内窥镜经眶入路(ETOA)正被广泛应用于颅底病变,尤其是眶隔脑膜瘤(SOMs)。这些肿瘤的复发率很高,二次手术往往是一个挑战。在本研究中,我们分析了通过略微改良的眼睑皱襞方法治疗复发性SOM的经验。2016年5月至2023年9月期间,意大利帕维亚IRCCS Policlinico San Matteo基金会神经外科连续采用经眶内镜方法治疗了5例复发性SOM。本文介绍了患者的人口统计学数据、术前缺陷、病变特征、组织学、切除等级、最终辅助治疗、并发症、症状改善和外观效果以及住院情况。其中一名患者术前已出现右侧直肌麻痹,但未报告有脑脊液(CSF)漏。所有患者术后均出现眶周水肿,但未发现其他全身并发症。所有患者的眼球突出都得到了改善,两名患者的视力得到了改善,所有病例都获得了最佳美容效果。住院时间从 4 天到 6 天不等。ETOA治疗复发性SOMs安全、疗效好。正确选择患者是必要的,但在可行的情况下,内窥镜手术可以为之前做过手术的肿瘤提供一条处女通道,从而保证了良好的战略选择。
Endoscopic transorbital approach for recurrent spheno-orbital meningiomas: single center case series.
Endoscopic transorbital approaches (ETOAs) are finding wide application for skull base lesions, particularly for spheno-orbital meningiomas (SOMs). These tumors have high recurrence rates, and second surgery can often represent a challenge. In this study we analyze our experience of management of recurrent SOMs through a slightly modified eyelid crease approach. Between May 2016 and September 2023, in the Department of Neurosurgery of Fondazione IRCCS Policlinico San Matteo (Pavia, Italy), five consecutive recurrent SOMs have been treated using an endoscopic transorbital approach. Demographic data, preoperatory deficits, lesions characteristics, histology, grade of resection, eventual adjuvant treatments, complications, outcome in terms of symptoms improvement and cosmesis, and hospitalization are described. One patient maintained a right lateral rectus muscle palsy that was already present in the preoperatory, no cerebrospinal fluid (CSF) leaks were reported. All patients had postoperative periorbital edema, but no other systemic complication was found. All patients had proptosis improvement, two had visual acuity improvement, and best cosmetic outcome was obtained in all cases. Hospitalization varied between 4 and 6 days. ETOAs in the management of recurrent SOMs are safe and have good outcome. Right selection of patients is mandatory, but when feasible, endoscopic surgery can allow a virgin route to a previously operated tumor, guaranteeing a good strategic option.
期刊介绍:
The goal of Neurosurgical Review is to provide a forum for comprehensive reviews on current issues in neurosurgery. Each issue contains up to three reviews, reflecting all important aspects of one topic (a disease or a surgical approach). Comments by a panel of experts within the same issue complete the topic. By providing comprehensive coverage of one topic per issue, Neurosurgical Review combines the topicality of professional journals with the indepth treatment of a monograph. Original papers of high quality are also welcome.