In neurosurgery, the brain is processed, and the surgical path through the nose sphenoid sinus is vividly called the nasal butterfly approach.

The nasal butterfly approach must be minimally invasive surgery. Like other minimally invasive surgeries in neurosurgery, it uses a small opening leading to the inside of the craniocerebral brain.

Minimally invasive surgery has the limitations of minimally invasive surgery. We have already discussed this last surgery case of taking parasites. After the surgical instrument is entered from a small incision, the theoretically speaking, this opening will form a roughly conical limit surgical area. If the part beyond the limit area, the instrument cannot reach or perform the surgery.

For nasal butterfly approach surgery, the central area of ​​the best surgical area is the central area where the sphenoid sinus enters. I will name it again to the butterfly area we mentioned at the beginning.

The surgical area that can be treated by nasal butterfly surgery basically revolves around the saddle area. In addition to the saddle area, some lesions in the slope area next to the saddle area near the saddle area will be treated as much as possible if the doctor can see with a nasaloscope.

Going into the nose for surgery without having to open a craniotomy, not even a hole is used to leave no scars, it sounds like a better surgical path than a minimally invasive hole. Patients must like this kind of surgery the most.

Not to mention patients, doctors also like it.

What I like is not the trouble of opening holes or not opening holes, but if you don’t walk through the nose, if the doctor wants to open the skull for the patient to perform surgery, he can only start from both sides of the head. These surgical approaches are not exceptional. The paths experienced are long, there are many brain tissues to pass through, and it cannot bypass the important area of ​​the eyes.

We have said before that we are most afraid of inadvertently harming other normal brain tissues and neurovascular vessels during surgery. If you can surround it, it is the best surgical method. Therefore, the three-dimensional positioning of neurosurgery has been repeatedly mentioned to the most important point.

Look at this way, the patient wants to do a nasal butterfly surgery. Whether the doctor can do it depends on the patient's condition is also the patient's luck. See if the tumor can grow just right under the doctor's nose and the surgical instruments can reach it.

The most appropriate tumor in this place should be a pituitary adenoma, because the pituitary gland is located in the sellarean area. The best indication for nasal butterfly surgery is a regular pituitary adenoma.

Another type of tumor that is more appropriate is craniopharyngioma. The craniopharyngioma connects the pituitary gland and the pharyngitubulum to the pharyngitubulum later degenerates and disappears, so most of the tumors grown here are benign tumors caused by congenital factors. If it is related to the pituitary gland, it is naturally a surgery that the pituitary gland can do. As long as it grows in a position that meets the place, it can also be done through the nasal butterfly.

Since the surgical area of ​​transnasal butterfly approach is too limited, if the tumor just grows a little beyond this surgical area, I really want to continue the surgery with nasal butterfly approach, is there a more flexible way to solve it?

In surgical operations, it is usually a small situation that occurs when you enter the surgical field. We have said in countless cases before that the most useful way to expand the surgical field is to expand the incision.

The same principle is used in the nasal butterfly approach surgery. The sphenoid sinus is broadened again, which is called enlarged sphenoid sinus incision, which removes the sphenoid mucosa and part of the posterior ethmoid sinus.
Chapter completed!