Artikel
Endoscopic endonasal surgery for disease involving skull base
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Veröffentlicht: | 4. April 2012 |
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To evaluate value of endoscopic endonasal approach in surgery of disease involving skull base.Clinical data of 189 cases with skull base lesions treated by endoscopic endonasal surgery were analyzed retrospectively from May 2002 to Dec. 2010.There were 47 cerebrospinal fluid eaks 5 meningoencephalocele,26 pituitary adenoma,15 sphenoethmoidal,4 rhinosinusitis,19 fungal rhinosinusitis,21 inverted papilloma,10 nasopharyngeal fibroangioma, 4 ossifying fibroma,4 fibrous dyspisia, 9 chordoma,4 craniopharyngioma,18 squamous cell carcinoma,1 undifferentiated carcinoma and 2 papilloma carcinomatous change. Middle turbinate mucosa, fascia lata, and abdominal fat were used in the CSF leak repair. The CSF fistula were closed by the combined multilayer“nderlay”“overlay” or “Bath-plug”techniques.Follow-up ranged from 6 to 60 months.Thirty-six CSF leaks cases were repaired successfully at the first time,six cases succeed at the second attempt,five cases succeed at the third attempt,ultimately 100% of the leaks were closed. The first attempt success rate of patients with large size(>10 mm) leaks was significantly lower than that of patients with small size(<10 mm) leaks.One meningoencephalocele patient recurred with CSF leaks,one fungal rhinosinusitis and three inverted papilloma recurred.Lesions were removed subtotally in 26 patients,included 13 squamous cell carcinoma,1 undifferentiated carcinoma,7 chordoma,3 craniopharyngioma and 2 fibrous dyspisia.One CSF leaks patient had postoperative intracranial infection and one CSF leaks patient had postoperative hydrocephalus.Endoscopic transnasal surgery is a safe,effective and minimally invasive approach to treat skull base disease. We should strictly control operate indication,especially for malignant tumors.