在中线入路期间需要侧化或动员颈内动脉 (ICA)，以暴露 ICA 后面或侧面的病变。然而，目前还没有关于内窥镜鼻内颈内动脉转位技术（EEITT）手术结果的公开数据。本研究旨在分析 ICA 周围的相关手术解剖结构，并提出 EEITT 分级方案。对在单一机构接受 EEITT 的患者进行回顾性评价。基于限制ICA的结构和术中发现，提出了EEITT的解剖学手术分级方案。纳入42例患者（平均年龄45.6岁，57.1％女性患者）。其中，Knosp 4级垂体腺瘤29例（69.0%），脊索瘤6例（14.3%），脑膜瘤6例（14.3%），脑膜IgG4相关疾病1例（2.4%）。 EEITT分为1级、2级和3级，分别有24例（57.1%）、12例（28.6%）和6例（14.3%）使用。最常见的症状是视力障碍（45.2%）。 1级（79.2%）和2级（83.3%）的毛全切除率远高于3级（66.6%）。视功能改善、术前颅神经（CN）麻痹改善和术后激素缓解的总体率分别为89.4%、85.7%和88.9%。以下疾病的发生率为脑脊液漏，2.4%；永久性尿崩症，4.8%；新发短暂性 CN 麻痹，9.5%；永久性 CN 麻痹，4.7%；全垂体功能减退症，7.1%； ICA损伤2.4%。EEITT在技术上是可行的，可以根据限制结构断开的程度进行分级。对于具有鞍旁扩展的复杂肿瘤，区分 1、2 和 3 级将有利于临床医生预测风险、避免并发症和制定量身定制的个体化手术策略。版权所有 © 神经外科医生大会 2024。保留所有权利。

Lateralization or mobilization of the internal carotid artery (ICA) during a midline approach is required to expose lesions behind or lateral to the ICA. However, there have been no published data regarding the surgical outcomes of the endoscopic endonasal internal carotid transposition technique (EEITT). This study aimed to analyze the relevant surgical anatomy around the ICA and propose a grading scheme of EEITT.A retrospective review of patients who underwent EEITT at a single institution was performed. Based on structures that limited the ICA and intraoperative findings, an anatomically surgical grading scheme of EEITT was proposed.Forty-two patients (mean age 45.6 years, 57.1% female patients) were included. Of them, 29 cases (69.0%) were Knosp grade 4 pituitary adenoma, 6 cases (14.3%) were chordoma, 6 cases (14.3%) were meningioma, and a single case (2.4%) was meningeal IgG4-related disease. The EEITT was categorized into Grades 1, 2 and 3, which was used in 24 (57.1%), 12 (28.6%), and 6 (14.3%) cases, respectively. The most common symptom was visual disturbance (45.2%). The gross total resection rate in Grade 1 (79.2%) and Grade 2 (83.3%) was much higher than that in Grade 3 (66.6%). The overall rate of visual function improvement, preoperative cranial nerve (CN) palsy improvement, and postoperative hormonal remission was 89.4%, 85.7%, and 88.9%, respectively. The rate for the following morbidities was cerebrospinal fluid leakage, 2.4%; permanent diabetes insipidus, 4.8%; new transient CN palsy, 9.5%; permanent CN palsy, 4.7%; panhypopituitarism, 7.1%; and ICA injury, 2.4%.The EEITT is technically feasible and could be graded according to the extent of disconnection of limiting structures. For complex tumor with parasellar extensions, the distinction into Grades 1, 2, and 3 will be of benefit to clinicians in predicting risks, avoiding complications, and generating tailored individualized surgical strategies.Copyright © Congress of Neurological Surgeons 2024. All rights reserved.