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・脳神経外科手術では,多種多様な手術器具・機器が日々開発され,その進歩は手術戦略に影響を与え,手術精度の向上に寄与している.
・特に頭蓋底外科手術においては,ハイスピードドリルや超音波吸引器は安全で確実な病変の摘出に大きく寄与しており,これらの特性を習熟し適切に使いこなすことが肝要である.
・本稿では頭蓋底外科手術におけるハイスピードドリルの安全な使い方,超音波吸引器の吸引および骨切モードの使い方について解説する.
During surgery for skull base lesions, maximum efforts should be made to improve the removal rate of the lesion while avoiding complications, and it is necessary to expand the surgical field by selecting appropriate surgical instruments and equipment. In both microsurgery and endoscopic surgery, high-speed drills and ultrasonic aspirators contribute significantly to the safe and reliable removal of skull base lesions, and the surgeons need to be familiar with these characteristics. The specific vital points are as follows: ① Preparation of the appropriate environment for using a high-speed drill or an ultrasonic aspirator with the understanding of the microsurgical anatomy, ② Bone excision using a high-speed drill with the selection of an appropriate drill attachment or drill bar tip according to the site of use, ③ Internal decompression of lesions using an ultrasonic aspirator with appropriate settings, ④ Additional expansion of the surgical field by using an ultrasonic aspirator in the osteotomy mode, and so on. This section describes details of how to use a high-speed drill and an ultrasonic aspirator during skull base surgery.
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