Сравнительный анализ эндоскопической трансназальной и микрохирургической трансоральной одонтоидэктомии: обзор литературы и собственный опыт
- Авторы: Шкарубо А.Н.1,2, Назаренко А.Г.3, Чернов И.В.1, Андреев Д.Н.1, Кулешов А.А.3, Коновалов Н.А.1, Лисянский И.Н.3, Синельников М.Е.4
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Учреждения:
- НМИЦ нейрохирургии имени академика Н.Н. Бурденко
- Российская медицинская академия непрерывного профессионального образования
- НМИЦ травматологии и ортопедии им. Н.Н. Приорова
- Первый Московский государственный медицинский университет им. И.М. Сеченова (Сеченовский Университет)
- Выпуск: Том 30, № 1 (2023)
- Страницы: 41-62
- Раздел: Оригинальные исследования
- URL: https://ogarev-online.ru/0869-8678/article/view/254191
- DOI: https://doi.org/10.17816/vto321930
- ID: 254191
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Аннотация
Обоснование. В случае передней компрессии стволовых структур инвагинированным зубовидным отростком показано выполнение одонтоидэктомии, которую в настоящее время возможно проводить как трансоральным микрохирургическим, так и трансназальным эндоскопическим доступом.
Цель. Провести сравнительный анализ эндоскопической трансназальной и микрохирургической трансоральной одонтоидэктомии, выполненных первым автором работы.
Материалы и методы. Проанализированы результаты лечения 29 пациентов с патологическими состояниями, включающими переднюю компрессию стволовых структур инвагинированным зубовидным отростком. Из 29 пациентов 5 (17%) человек оперированы трансназально эндоскопически, 24 (83%) — трансорально микрохирургически.
Результаты. Во всех случаях (100%) удалось достичь декомпрессии стволовых структур. Отсутствие необходимости в установке трахеостомы перед операцией и меньший объём травмы ротоглотки позволяют пациентам, подвергшимся трансназальному удалению зубовидного отростка, переносить послеоперационный период легче и быстрее.
Заключение. В настоящее время эндоскопический трансназальный доступ постепенно замещает трансоральный у ряда пациентов, которым показана передняя одонтоидэктомия. При этом анализ данных литературы отображает всё более глубокое развитие этой методики, однако однозначных показаний к применению трансорального или трансназального доступа в настоящее время не сформулировано.
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Алексей Николаевич Шкарубо
НМИЦ нейрохирургии имени академика Н.Н. Бурденко; Российская медицинская академия непрерывного профессионального образования
Email: ashkarubo@nsi.ru
ORCID iD: 0000-0003-3445-3115
SPIN-код: 3420-3394
доктор медицинских наук, врач-нейрохирург
Россия, 125047, Москва, ул. 4-я Тверская-Ямская, д. 16; 123242 Москва, ул Баррикадная, д. 2/1, стр. 1Антон Герсимович Назаренко
НМИЦ травматологии и ортопедии им. Н.Н. Приорова
Email: cito@cito-priorov.ru
ORCID iD: 0000-0003-1314-2887
SPIN-код: 1402-5186
доктор медицинских наук, профессор РАН, врач травматолог-ортопед
Россия, 127299, Москва ул. Приорова, 10Илья Валерьевич Чернов
НМИЦ нейрохирургии имени академика Н.Н. Бурденко
Автор, ответственный за переписку.
Email: ichernov@nsi.ru
ORCID iD: 0000-0002-9789-3452
SPIN-код: 3550-1153
кандидат медицинских наук, врач-нейрохирург
Россия, 125047, Москва, ул. 4-я Тверская-Ямская, д. 16Дмитрий Николаевич Андреев
НМИЦ нейрохирургии имени академика Н.Н. Бурденко
Email: dandreev@nsi.ru
ORCID iD: 0000-0001-5473-4905
SPIN-код: 8516-7994
кандидат медицинских наук, врач-нейрохирург
Россия, 125047, Москва, ул. 4-я Тверская-Ямская, д. 16Александр Алексеевич Кулешов
НМИЦ травматологии и ортопедии им. Н.Н. Приорова
Email: Cito-spine@mail.ru
доктор медицинских наук, врач травматолог-ортопед
Россия, 127299, Москва ул. Приорова, 10Николай Александрович Коновалов
НМИЦ нейрохирургии имени академика Н.Н. Бурденко
Email: NAKonovalov@nsi.ru
ORCID iD: 0000-0003-0824-1848
SPIN-код: 9436-3719
доктор медицинских наук, член-корреспондент РАН, врач-нейрохирург
Россия, 125047, Москва, ул. 4-я Тверская-Ямская, д. 16Игорь Николаевич Лисянский
НМИЦ травматологии и ортопедии им. Н.Н. Приорова
Email: lisigornik@list.ru
SPIN-код: 9845-1251
кандидат медицинских наук, врач травматолог-ортопед
Россия, 127299, Москва ул. Приорова, 10Михаил Егорович Синельников
Первый Московский государственный медицинский университет им. И.М. Сеченова (Сеченовский Университет)
Email: snlnkv15@icloud.com
ORCID iD: 0000-0002-0862-6011
SPIN-код: 6341-0943
кандидат медицинских наук, врач-онколог
Россия, 119991, Москва, ул. Трубецкая, д. 8, стр. 2Список литературы
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