经口腔内窥镜在三维可视化及实时导航技术下切除咽旁及侧颅底良性肿瘤初探

Preliminary study on the resection of parapharyngeal and lateral skull base tumors by using transoral endoscopy with 3D visualization and navigation technologies

摘要

目的 开展在三维可视化技术及术中实时导航辅助下，采取经口腔入路内窥镜下切除咽旁及侧颅底肿瘤的初步研究。 方法 对8例咽旁或侧颅底区域的软组织肿瘤患者术前CT数据建模，通过三维可视化技术重建肿瘤与周围血管及其他重要结构的解剖位置关系，进行术前设计。术中采取经口腔入路，术中实时导航引导，内窥镜下切除咽旁及侧颅底软组织肿瘤，并评估该方法的临床应用价值。 结果 8名患者采用该技术进行手术，术中失血量均控制在150 mL以内，平均失血量约125 mL。术后患者并发症发生率低，通过术后功能训练，患者均能够获得良好恢复。因采用经口入路，患者术后面部皮肤无伤口无瘢痕，对患者容貌无影响。 结论 三维可视化技术、术中实时导航及内窥镜三者联合为咽旁肿瘤或侧颅底肿瘤患者提供了一种美观、安全、微创的手术方式。

Abstract

Objective With the assistance of 3D visualization and real-time navigation technologies, the tumors in the parapharyngeal and lateral skull base should be removed through oral the approach with endoscopy. Methods The preoperative CT data of eight patients with parapharyngeal or lateral skull base soft tissue tumors were modeled, and the anatomical position relationship between the tumor and surrounding blood vessels and other important structures was reconstructed using 3D visualization technology, and preoperative design was performed. The intraoperative oral approach and real-time navigation guidance were adopted in the endoscopic resection of soft tissue tumors in the parapharyngeal and lateral skull base, and the clinical application value of this method was evaluated. Results The blood loss during the operation was controlled within 150 mL, and the average blood loss was approximately 125 mL. The incidence of postoperative complications was low, and patients could recover well through functional training. The oral approach did not leave any wounds nor scars on the patient’s facial skin after the operation and had no effect on the patient's appearance. Conclusion The combination of 3D visualization technology, intraoperative real-time navigation, and endoscopy provides a beautiful, safe, and minimally invasive surgical method for patients with parapharyngeal or lateral skull base tumors.

关键词

三维可视化技术 / 导航技术 / 内窥镜 / 咽旁肿瘤 / 侧颅底肿瘤

Key words

3D visualization technology / navigation technology / endoscope / parapharyngeal tumor / lateral skull base tumor

Author summay

闫冰，副主任医师，博士，E-mail：[e-mail]