Chapter 3064： 【3064】Just right

Chapter 3064 [3064] Just right

In neurosurgery, the brain is treated, so the surgical approach through the sphenoid sinus of the nose is vividly called the sphenoid approach.

The sphenoid approach is definitely a minimally invasive surgery. Like other minimally invasive surgeries in neurosurgery, it uses a small opening leading to the inside of the skull.

Minimally invasive surgery has the limitations of minimally invasive surgery, which we have already mentioned in the last surgical case of removing parasites. Theoretically speaking, after the surgical instrument enters through the small incision, this opening will form a roughly conical limit operation area. Beyond the limit area, the instruments cannot reach and the operation cannot be performed.

For the sphenoid approach surgery, the central area of ​​the best surgical area is the central area where the sphenoid sinus enters, and once again we call the sella area that we mentioned at the beginning.

The surgical area that can be handled by sphenoid surgery basically revolves around the sellar area. In addition to the sellar area, some of the suprasellar area near the sellar area, the parasellar area and the **** area, etc., the doctor will help the patient as much as possible with the nasal speculum that can be seen.

Entering through the nose for surgery, without craniotomy, without even punching a hole, leaving no scars, it certainly sounds like a better surgical path than punching. The patient is definitely the favorite of this kind of surgery.

Not to mention patients, doctors like it as well.

What likes is not the trouble of opening the hole but not opening the hole, but if the doctor does not go through the nose, if the doctor wants to open the patient's skull for surgery, he can only start from the top and two sides of the head. These surgical approaches are not without exception, the journey through the journey is long, there is a lot of brain tissue to pass through, and the important area of ​​the eye cannot be bypassed.

Neurosurgery As we said before, we are most afraid of inadvertently injuring other normal brain tissue and nerve blood vessels during surgery. Revolving around is the best surgical method. Therefore, the three-dimensional localization of neurosurgery has repeatedly been mentioned as the most important point.

Looking at it this way, patients with sphenoid surgery want to be a doctor, and whether they can do it depends on the patient's condition and it is also the patient's luck. See if the tumor can grow just enough to be within the reach of surgical instruments under the doctor's nose.

The most suitable tumor in this place should be a pituitary adenoma, because the pituitary gland is located in the sella. The best indication for sphenoid surgery is a regular pituitary adenoma.

Another type of tumor that is just right is the craniopharyngioma. The craniopharynx connects the pituitary gland and the eustachian tube to a structure that later degenerates and disappears, so most of the tumors that grow here are benign tumors caused by congenital factors. It is related to the pituitary, and it is naturally a surgery that the pituitary can do. It can be done through the nasal sphenoid approach as long as it grows in a suitable position.

Because the surgical area of ​​the transsphenoidal approach is too limited, if the tumor just grows just a little beyond the surgical area, what can I do if I really want to continue using the nasal sphenoid approach? Is there a more flexible way to solve it?

In surgery, it usually happens that the surgical field is just a little smaller after entering the surgical field. As we have said in countless previous cases, the most simple and rude way to expand the surgical field is to expand the incision.

It is the same principle in the sphenoid approach. To widen the sphenoid sinus is called an extended sphenoid incision. The sphenoid mucosa and part of the posterior ethmoid sinus are removed.

After chatting with the patient, the Fangze people in the next room could finally hear the voice of their doctor Tong, and the people from the National Association perked up their ears one by one.