PDF(Pubmed)
Abstract：
We determined the feasibility of the combined exoscopic-endoscopic technique (CEE) as an alternative to the microscope in craniofacial resection (CFR). This retrospective study was conducted at a single institution and included eight consecutive patients with head and neck tumors who underwent CFR between September 2019 and July 2021. During the transcranial approach, microsurgery was performed using an exoscope in the same manner as in traditional microscopic surgery, and an endoscope was used at the blind spot of the exoscope. The exoscope provided images of sufficient quality to perform microsurgery, while the sphenoid sinus lumen was the blind spot of the exoscope during anterior (n = 3) and anterolateral CFR (n = 2), and the medial aspect of the temporal bone was the blind spot of the exoscope during temporal bone resection (n = 2). These blind spots were visualized by the endoscope to facilitate accurate transection of the skull base. The advantages of the exoscope and endoscope include compact size, ergonomics, surgical field accessibility, and equal visual experience for neurosurgeons and head and neck surgeons, which enabled simultaneous transcranial and transfacial surgical procedures. All the surgeries were successful without any relevant complications. CEE is effective in transcranial skull base surgery, especially CFR involving simultaneous surgical procedures.
摘要：
我们确定了在颅面切除术（CFR）中使用联合内镜技术（CEE）替代显微镜的可行性。这项回顾性研究是在一个机构进行的，包括8名在2019年9月至2021年7月期间接受CFR的头颈部肿瘤患者。在经颅入路期间，显微手术是使用外镜以与传统显微手术相同的方式进行的，并且在外镜的盲点处使用内窥镜。出镜提供了足够质量的图像来进行显微外科手术，而蝶窦腔是前（n=3）和前外侧CFR（n=2）期间的外镜检查盲点，颞骨的内侧是颞骨切除期间的外镜检查的盲点（n=2）。这些盲点通过内窥镜可视化，以促进颅底的准确横切。出镜和内窥镜的优点包括紧凑的尺寸，人体工程学,手术视野可及性，神经外科医生和头颈外科医生的视觉经验相同，这使得同时进行经颅和面部外科手术。所有手术均成功，无相关并发症。CEE在经颅颅底手术中有效，尤其是涉及同时外科手术的CFR。
