当前位置： SCI文献检索 > NEUROSURGERY期刊下所有文献 > Endoscope-assisted supraorbital craniotomy for lesions of the interpeduncular fossa.

Endoscope-assisted supraorbital craniotomy for lesions of the interpeduncular fossa.

Abstract：

OBJECTIVE:The supraorbital approach is well accepted for lesions in the anterior fossa, the sellar region, and the anterior circle of Willis. However, the usefulness of this approach has not yet been elucidated for lesions in the interpeduncular fossa. The technique of an endoscope-assisted, ipsi- and contralateral supraorbital approach to lesions within the interpeduncular fossa is described, and the initial results are reported. METHODS:A small supraorbital craniotomy, using an eyebrow incision, was performed in each of seven patients who were operated on for different types of lesions in the interpeduncular fossa, including a neuromuscular choristoma of the oculomotor nerve, a retrosellar epidermoid tumor, and five aneurysms (two of the basilar artery tip, two at the offspring of the superior cerebellar artery, and one fusiform arterial widening of the basilar artery apex). The surgical approach, its indications and limitations, and the additional value of an endoscope are outlined. RESULTS:All lesions could be easily reached and well visualized through this approach by using an endoscope as an adjunct to the operating microscope. The saccular aneurysms all could be clipped successfully, the fusiform widening was wrapped, the epidermoid tumor was removed completely, and the choristoma was removed only partially because of brain stem invasion. The patient with the neuromuscular choristoma had persistent diabetes insipidus postoperatively, most probably caused by stretching the pituitary stalk with the endoscope. The patient with the epidermoid tumor showed a postoperative transient partial oculomotor nerve paresis at the side of the approach. The cosmetic results of the eyebrow incisions for this approach were excellent in all patients. CONCLUSION:Lesions in the interpeduncular fossa can be effectively treated using a supraorbital approach, which can be ipsi- or contralateral to the side of the lesion, depending on the exact location of the lesion. The use of an endoscope is essential to visualize these lesions that lie in the shadow of the sellar and parasellar anatomic structures. The major advantage over other approaches are a nearly perpendicular surgical route (although the distance is longer, which is, on the other hand, not a disadvantage), a minimized amount of dissection and brain retraction by using an endoscope through anatomic gateways, and a small surgical incision with excellent cosmetic results.

journal_name

Neurosurgery

journal_title

Neurosurgery

authors

Menovsky T,Grotenhuis JA,de Vries J,Bartels RH

doi

10.1097/00006123-199901000-00062

subject

Has Abstract

pub_date

1999-01-01 00:00:00

pages

106-10; discussion 110-2

issue

eissn

0148-396X

issn

1524-4040

journal_volume

pub_type

杂志文章

在线工具

Endoscope-assisted supraorbital craniotomy for lesions of the interpeduncular fossa.