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文献概要
解剖を中心とした脳神経手術手技
内視鏡下経鼻手術における鼻・副鼻腔機能の温存
著者： 藤本康倫1 端山昌樹2 吉峰俊樹3
所属機関： 1大阪大学大学院医学系研究科脳神経外科 2大阪大学大学院医学系研究科耳鼻咽喉科・頭頸部外科 3大阪大学国際医工情報センター
ページ範囲：P.1009 - P.1017
文献購入ページに移動Ⅰ．はじめに
トルコ鞍周囲病変さらには頭蓋底外側病変に対する内視鏡下経鼻手術（endoscopic endonasal surgery：EES）の発展は，内視鏡画像の鮮明化や周辺機器の発達のみならず，特に海外から始まった脳神経外科医と耳鼻咽喉科医の知識と経験を活かしたtwo-surgeon technique（four-hands technique）の導入によるところが大きい．内視鏡下経鼻頭蓋底手術の黎明期においては，許容される範囲内とはいえ鼻腔内環境を犠牲にしつつ，術野（surgical corridor）の拡大と重大な合併症である術後髄液漏の予防が優先されてきたが，その後髄液漏予防のためのさまざまな工夫がなされるようになり，鼻腔構造に対する最小限の侵襲と十分な術野確保の両立が図られるようになった．本稿では，EESにおける鼻・副鼻腔に関する基本的手術解剖と生理機能，およびその機能温存の工夫について述べる．
トルコ鞍周囲病変さらには頭蓋底外側病変に対する内視鏡下経鼻手術（endoscopic endonasal surgery：EES）の発展は，内視鏡画像の鮮明化や周辺機器の発達のみならず，特に海外から始まった脳神経外科医と耳鼻咽喉科医の知識と経験を活かしたtwo-surgeon technique（four-hands technique）の導入によるところが大きい．内視鏡下経鼻頭蓋底手術の黎明期においては，許容される範囲内とはいえ鼻腔内環境を犠牲にしつつ，術野（surgical corridor）の拡大と重大な合併症である術後髄液漏の予防が優先されてきたが，その後髄液漏予防のためのさまざまな工夫がなされるようになり，鼻腔構造に対する最小限の侵襲と十分な術野確保の両立が図られるようになった．本稿では，EESにおける鼻・副鼻腔に関する基本的手術解剖と生理機能，およびその機能温存の工夫について述べる．
参考文献
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