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Application of endoscopic endonasal approach in skull base surgeries: summary of 1886 cases in a single center for 10 consecutive years

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Chinese Neurosurgical Journal 2020年第3期6卷 133-140页

作者： Chuzhong Li Haibo Zhu Xuyi Zong Xinsheng Wang Songbai Gui Peng Zhao Chunhui Liu Jiwei Bai Lei Cao Yazhuo Zhang Beijing Neurosurgical Institute Capital Medical UniversityBeijingChina Department of Neurosurgery Beijing Tiantan Hospital affiliated to Capital Medical UniversityBeijingChina Beijing Institute for Brain Disorders Brain Tumor Center BeijingChina China National Clinical Research Center for Neurological Diseases No.119 South 4th Ring West RoadFengtai DistrictBeijing 100050China

Background:endonasal endoscopic skull base surgery has undergone rapid technological developments and is now widely performed,but its strengths and weaknesses deserve further investigation and *** study was performed to investigate the surgical indications,complications,and technical advantages and disadvantages of endonasal endoscopic skull base ***:The clinical data of 1886 endoscopic endonasal skull base surgeries performed in our ward at Beijing Tiantan Hospital from June 2006 to June 2016 were retrospectively ***:One thousand ninety-three(73.4%,1490)pituitary adenomas,54(24.9%,217)chordomas,28(80.0%,35)craniopharyngiomas,and 15(83.3%,18)meningiomas underwent total *** patients died postoperatively,both having pituitary *** postoperative complications included olfactory disorders(n=226,11.9%),postoperative cerebrospinal fluid leakage(n=78,4.1%),hypopituitarism(n=74,3.9%),diabetes insipidus(n=64,3.4%),intracranial infection(n=36,1.9%),epistaxis(n=24,1.3%),vascular injury(n=8,0.4%),optic nerve injury(n=8,0.4%),and oculomotor movement impairment(n=4,0.2%).In total,1517(80.4%)patients were followed up for 6 to 126 months(average,42.5 months)postoperatively.A total of 196(13.2%)pituitary adenomas and 13(37.1%)craniopharyngiomas recurred but no meningiomas *** recurred in 97(44.7%)patients,in whom 5-year survival rate was 65%.Conclusion:Endoscopic surgery is an innovative surgical technique and the first choice for most midline extradural lesions such as chordomas,and an excellent choice for pituitary *** probably will be a good technique for many kinds of craniopharyngiomas and a common technique for most of skull base meningiomas,so the surgical indications of these cases should be chosen carefully to make good use of its respective advantages.

关键词： Complication Indication Neuroendoscopy Skull base surgery endonasal approach

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Expanded Endoscopic endonasal approach (EEEA) for Clival Chordomas

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Open Journal of Modern Neurosurgery 2020年第3期10卷 334-344页

作者： Waleed Abbass Amr Mohsen Department of Neurosurgery Faculty of Medicine Cairo University Giza Egypt

Objective: To evaluate the role of expanded endoscopic endonasal approach in removal of clival chordomas. Patients & Methods: Nine patients with clival chordomas were operated upon in Cairo University hospital from September 2015 to September 2018 using the EEEA a recurrent case and seven new cases were involved in these study and ten operations were done. All patients had preoperative neurological and radiological examination. The study was focusing on the approach, efficacy of tumor removal, reconstruction of the base and complications related to this approach. Results: Nine patients were operated in this study in which ten operations were done. It included six males (66.6%) and three females (33.3%) with age ranging from 4 years to 63 years with average age 40.7 years. Headache and diplopia were the most common symptoms found in six patients (66.6%). Brainstem affection was found in two patients (22.2%). Lower cranial nerves affection was found in two patients (22.2%). One case developed CSF leakage postoperatively (11.1%). Two patients underwent tracheostomy. We achieve total removal in four patients (44.4%), near total removal in one patient (11.1%) and subtotal tumor resection in four patients (44.4%). Conclusion: EEEA for clival chordomas is safe and effective approach regarding the results of the incidence of complications, and the percentage of tumor resection.

关键词： Endoscopic endonasal approach Clival Chordomas

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Clinical application of reserved gastric tube in neuroendoscopic endonasal surgery for pituitary tumor

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World Journal of Clinical Oncology 2024年第3期15卷 411-418页

作者： Xi Chen Long-Yao Zhang Zhi-Feng Wang Yi Zhang Yu-Hua Yin Xue-Jian Wang Department of Nursing Affiliated Hospital 2 of Nantong UniversityNantong 226000Jiangsu ProvinceChina Department of Neurosurgery Affiliated Hospital 2 of Nantong UniversityNantong 226000Jiangsu ProvinceChina Department of Neurosurgery Renji HospitalShanghai Jiao Tong UniversityShanghai 226000China

BACKGROUND The neuroendoscopic approach has the advantages of a clear operative field,convenient tumor removal,and less damage,and is the development direction of modern *** present,transnasal surgery for sphenoidal pituitary tumor is widely *** it has been found in clinical practice that some patients with this type of surgery may experience post-operative nausea and vomiting and other *** To explore the effect of reserved gastric tube application in the neuroendoscopic endonasal resection of pituitary *** A total of 60 patients who underwent pituitary adenoma resection via the endoscopic endonasal approach were selected and randomly divided into the experimental and control groups,with 30 in each *** group:After anesthesia,a gastric tube was placed through the mouth under direct vision using a visual laryngoscope,and the fluid accumulated in the oropharynx was suctioned intermittently with low negative pressure throughout the whole process after nasal disinfection,during the operation,and when the patient recovered from *** group:Given the routine intraoperative care,no gastric tube was *** number of cases of nausea/vomiting/aspiration within 24 h post-operation was counted and compared between the two groups;the scores of pharyngalgia after waking up,6 h post-operation,and 24 h *** frequency of postoperative cerebrospinal fluid leakage and intracranial infection were *** hospitalization days of the two groups were statistically *** The times of postoperative nausea and vomiting in the experimental group were lower than that in the control group,and the difference in the incidence of nausea was statistically significant(P<0.05).After the patient woke up,the scores of sore throat 6 h after the operation and 24 h after operation were lower than those in the control group,and the difference was statistically significant(P<0.05).The number of cases of postope

关键词： Neuroendoscopy endonasal approach Pituitary tumor Reserved gastric tube Nausea Vomiting Aspiration Complications

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Endoscopic expand transnasal approach to the suprasellar region ： anatomical study and clinical considerations

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Chinese Medical Journal 2009年第20期122卷 2444-2448页

作者： LU Xiao-jie CHEN Kai-lai WANG Qin JI Wei-yang LI Bing SUN Ji-yong LI Jiang-an Department of Neurosurgery Wuxi 2nd People's Hospital Wuxi Jiangsu 214002 China

Backgroud The expanded endonasal approach （EEA） is used sparingly by surgeons for resection of lesions in the ventrocranial base. Herein, we examined the anatomy of the ventrocranial base by endoscopy and comment on the use of EEA in clinical practice. Methods Twenty artery-injected adult cadaveric heads were studied under surgical conditions using the endoscopic EEA. The extent of the surgical exposure, the endoscopic anatomic view and the maneuverability of surgical instruments about the suprasellar region were studied by the endoscopic EEA. Results The EEA by endoscope can reach the suprasellar region. In this approach, the optocarotid recess, supra and infra-optic chiasm interspace, the ophthalmic artery and others were important anatomical landmarks for identification of the suprasellar region. Conclusions The endoscopic EEA can be used to remove many types of lesions in the ventrocranial base. The microanatomy observed using the endoscope provides important anatomical information on the suprasellar region for neurosurgeons.

关键词： endoscopy sellar region endonasal approach anatomy

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