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内視鏡的経眼窩的アプローチによる再発性海綿状髄膜腫の治療
Francesco Paglia1, Lorenzo Sgarbanti2, Ben Chat-Fong Ng3
1Human Neurosciences Department, University La Sapienza, Rome, Italy.
Neurosurgical focus: Video
|January 22, 2026
まとめ
経眼窩的内視鏡的アプローチは、前床突起髄膜腫に対する低侵襲手術選択肢を提供し、脳牽引および合併症を軽減する。この手技は、選択された頭蓋底症例において、安全性向上を伴う効果的な腫瘍切除を提供する。
科学分野:
- 脳神経外科; 頭蓋底外科; 内視鏡下手術
背景:
- 前床突起髄膜腫は、重要な神経血管構造への近接性から、手術上の課題を提示する。従来の外科的方法は、大幅な骨削除と脳牽引を伴い、合併症のリスクを高める。
研究 の 目的:
- 前床突起髄膜腫切除における低侵襲代替法としての経眼窩的内視鏡的アプローチを評価すること。複雑な頭蓋底腫瘍の管理におけるこのアプローチの実現可能性と安全性を実証すること。
主な方法:
- 外科的アクセスとして経眼窩的内視鏡的通路を利用した。脳組織の操作を最小限に抑えながら腫瘍切除を行った。再発性の非定型前床突起髄膜腫の症例検討を提示した。
主要な成果:
- 経眼窩的内視鏡的アプローチは、前頭蓋底および海綿静脈洞周囲領域への直接的なアクセスを提供した。この手技により、脳牽引を軽減しつつ効果的な腫瘍切除が可能となった。この選択された頭蓋底症例において、このアプローチは実現可能かつ安全であることが判明した。
結論:
- 経眼窩的内視鏡的アプローチは、前床突起髄膜腫に対する実行可能で低侵襲な選択肢である。この手技は、特定の頭蓋底病変に対して、従来の開頭手術よりも安全な代替法を提供する可能性がある。
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