頭蓋底腫瘍における内視鏡手術

Endoscopic Surgery for Skull Base Tumors

Point

・内視鏡および周辺器具の発達に伴い，頭蓋底腫瘍に対する経鼻あるいは経頭蓋の内視鏡手術が普及しつつある．

・頭蓋底腫瘍は，しばしばさまざまな重要な神経血管組織に近接しているため，安全に摘出を行うためには，適切なアプローチルートを検討することが重要である．

・安全かつ最大限の腫瘍摘出を行うために，当院で普段行っている術前シミュレーションについて報告する．

　With the development of endoscopic and peripheral instruments, endonasal or transcranial endoscopic surgery for skull-base tumors has become more common. Preoperative simulation makes it relatively easy to understand the anatomical relationship between skull base tumors and the surrounding vital structures, which vary with each case. This may lead to the avoidance of complications and an improvement in the removal rate. Especially in cases of skull base tumors where multiple surgical approaches are possible, the three-dimensional model can be used to confirm the surgical field for each approach and consider the most appropriate.

　With the development of endovascular treatment and radiotherapy, experience in craniotomy has decreased. Young neurosurgeons need to develop skills to learn as efficiently as possible from their limited experience. Therefore, it is extremely useful to provide an environment that allows for easier preoperative simulations.