内窥镜鼻内入路治疗视神经通路-下丘脑胶质瘤：1例儿科病例报告和系统回顾。

IF 1.9 4区医学 Q3 CLINICAL NEUROLOGY

Journal of Clinical Neuroscience Pub Date : 2025-01-18 DOI:10.1016/j.jocn.2025.111052

Nicolás Rincón-Arias , Paula A. Pulido , Yamila Micaela Zampini , Nicolás Llanos Orozco , Martín Pinzón , Giovanni Barbagli , Fernando Hakim , Diego F. Gómez-Amarillo , Edgar G. Ordoñez-Rubiano

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引用次数: 0

摘要

背景：内窥镜鼻内入路（EEA）通过提供病变神经解剖的精确可视化和减少大脑操作，彻底改变了视神经通路-下丘脑胶质瘤（ophg）的治疗前景。尽管ophg的临床发展轨迹不同，但最佳的神经外科治疗策略仍然是一个有争议的话题。方法：我们报告了一例8岁女性OPHG患者，她接受了EEA治疗，并对2007年1月（首次报告病例的日期）至2024年6月的英语和西班牙语病例报告进行了系统的回顾检索，重点是EEA治疗的OPHG。PubMed、Lilacs、Embase等数据库。检索结果：我们的系统综述包括30例用EEA治疗的ophg。多数患者（86.6%）表现为视觉障碍，43.3%表现为头痛，30%表现为内分泌障碍。总全切除（GTR）占20%，小全切除占40%，近全切除占20%。组织学上，毛细胞星形细胞瘤占主导地位（73.3%），临床表现不同，需要量身定制的治疗方法。结论：EEA为视神经通路和下丘脑区提供了安全的通道。尽管与其他方法相比，实现GTR存在局限性，但EEA在临床改善和神经解剖保存方面的优势使其成为某些ophg病例的有价值的选择。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

Endoscopic endonasal approach for optic Pathway–Hypothalamic Glioma: A pediatric case Report and a Systematic review

查看原文本刊更多论文

Endoscopic endonasal approach for optic Pathway–Hypothalamic Glioma: A pediatric case Report and a Systematic review

Background

The Endoscopic Endonasal Approach (EEA) has revolutionized the treatment landscape for optic pathway–hypothalamic gliomas (OPHGs) by providing precise visualization of the lesion neuroanatomic and minimizing brain manipulation. Despite the variable clinical trajectories of OPHGs, the optimal management neurosurgical strategy continues to be a subject of debate.

Methods

We present a case of an 8-year-old female with an OPHG who underwent EEA and performed a systematic review search in English and Spanish case reports from January 2007 (date of first reported case) to June 2024, focusing on OPHG treated with EEA. Databases such as PubMed, Lilacs, and Embase.

Search results

Our systematic review encompassed 30 cases of OPHGs treated with EEA. Most patients (86.6%) presented with visual disturbance, 43.3% with headaches, and 30% with endocrine disturbances. Gross-total resection (GTR) was achieved in 20%, subtotal in 40%, and near-total in 20%. Histologically, pilocytic astrocytoma predominated (73.3%), with varied clinical presentations highlighting the need for tailored management approaches.

Conclusions

The EEA offers safe access to the optic pathway and hypothalamic region. Despite limitations in achieving GTR compared to other approaches, EEA’s benefits in clinical improvement and neuroanatomical preservation make it a valuable option for select cases of OPHGs.

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来源期刊

Journal of Clinical Neuroscience 医学-临床神经学

CiteScore

4.50

自引率

0.00%

发文量

402

审稿时长

40 days

期刊介绍： This International journal, Journal of Clinical Neuroscience, publishes articles on clinical neurosurgery and neurology and the related neurosciences such as neuro-pathology, neuro-radiology, neuro-ophthalmology and neuro-physiology. The journal has a broad International perspective, and emphasises the advances occurring in Asia, the Pacific Rim region, Europe and North America. The Journal acts as a focus for publication of major clinical and laboratory research, as well as publishing solicited manuscripts on specific subjects from experts, case reports and other information of interest to clinicians working in the clinical neurosciences.