Minimal invasive trans-eyelid approach to anterior and middle skull base meningioma: a preliminary study of Shanghai Huashan hospital.
Minimal invasive trans-eyelid approach to anterior and middle skull base meningioma: a preliminary study of Shanghai Huashan hospital.
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微创经眼睑入路治疗前中颅底脑膜瘤：上海华山医院的初步研究。
DOI：
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发表时间：
2014-11
期刊：
影响因子：
--
通讯作者：
宫晔
中科院分区：
文献类型：
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作者：
谢清;汪戴军;孙礼;毛颖;钟平;郑明哲;汤海亮;朱宏达;陈衔城;周良辅;宫晔
经睑或经睑入路是一种改良的经眶入路，可治疗前颅窝及鞍区病变。但该入路是否也适用于向外侧延伸至颞叶或颅中窝的肿瘤尚不清楚。我们愿意分享从尸体解剖研究到临床手术的经验。我们用5具尸体一步一步地研究跨眼皮手术。在一位经验丰富的眼科医生的协助下，我们通过该入路治疗了3例女性患者：蝶眶脑膜瘤1例，鞍结节脑膜瘤1例，蝶翼内侧脑膜瘤1例。在研究了尸体后，我们对之前报道的方法做了一些修改：1)将切口靠近眼睑边缘，类似于双眼皮切口。2)解剖带血管的骨膜瓣修复额窦开口，重建颅底。3)用颞肌切片缝合硬脑膜。然后我们用这种方法治疗了3例患者。所有肿瘤均被全部切除为Simpson i级。并发症包括眼眶尖综合征和因肿瘤侵入眼眶和海绵窦而引起的一过性动眼瘫。无脑脊液漏。我们发现，跨睑入路不仅适用于前颅底或鞍区病变，也适用于中颅底病变，特别是蝶翼周围2 cm范围内或蝶眶区病变。因此，我们建议将这种入路命名为“跨眼睑翼点入路”是否合适，因为它可以通过翼点周围的小开颅术治疗一些颅前和颅中窝病变。
Transpalpebral or trans-eyelid approach is a modified trans-orbital access to lesions of anterior cranial fossa and sellar region. But whether this approach is also suitable for tumors extending laterally to the temporal lobe or middle cranial fossa is not clarified. We would like to share our experiences from the cadaveric anatomy study to clinical operations. We used 5 cadavers to study trans-eyelid approaches in a step-by-step fashion. And then assisted by an experienced ophthalmologist for incisions, we treated 3 female patients via this approach: One with spheno-orbital meningioma, one with sellar tuberculum meningioma, and the other with medial sphenoidal wing meningioma. After studying the cadavers, we made several revisions to the previously reported approach: 1) move the incision close to the edge of the eyelid, which resembled the double-eyelid incision. 2) A vascularized periosteum flap was dissected for repairing the opened frontal sinus and reconstruction of the skull base. 3) The dura was sutured up with a slice of temporalis muscle. Then we treated 3 patients by this approach. All tumors were totally resected as Simpson Grade I. Complications included orbital apex syndrome and transient oculomotor paralysis because of tumor invasion into orbit and cavernous sinus. No cerebrospinal fluid leakage. We find that trans-eyelid approach is suitable for lesions not only at anterior cranial base or sellar region, but also extending to middle cranial base, especially around sphenoidal wings within 2 cm range or spheno-orbital region. Thus, we propose whether it appropriate to nominate this approach as 'trans-eyelid pterional approach', since it may treat some anterior and middle cranial fossa lesions with a mini-craniotomy around pterion.
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DOI：
10.1055/s-0030-1254330
发表时间：
2010-06
期刊：
Facial Plast Surg
影响因子：
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作者：
Amir Karam1;Samuel Lam2
通讯作者：
Amir Karam1;Samuel Lam2
影响因子：
4.3
作者：
S. Raza;K. Boahene;A. Quiñones‐Hinojosa
通讯作者：
S. Raza;K. Boahene;A. Quiñones‐Hinojosa
DOI：
10.1016/j.otohns.2010.01.009
发表时间：
2010-06
期刊：
Otolaryngology–Head and Neck Surgery
影响因子：
--
作者：
E. Chu;A. Quiñones‐Hinojosa;K. Boahene
通讯作者：
E. Chu;A. Quiñones‐Hinojosa;K. Boahene
影响因子：
--
作者：
Jho, HD
通讯作者：
Jho, HD
DOI：
10.1053/joms.2001.18271
发表时间：
2001-02
期刊：
Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons
影响因子：
--
作者：
B. Schmidt;M. Pogrel;Z. Hakim-Faal
通讯作者：
B. Schmidt;M. Pogrel;Z. Hakim-Faal