神经内镜辅助眶上锁孔入路切除鞍结节脑膜瘤

目的总结内镜辅助下经眶上锁孔入路显微手术切除鞍结节脑膜瘤的手术效果。方法13例鞍结节脑膜瘤采用眶上锁孔入路,先在显微镜直视下切除部分肿瘤,再在内镜辅助下切除残余肿瘤。结果肿瘤全切除12例（SimpsonⅠ级切除2例,Ⅱ级切除10例）,次全切除1例（SimpsonⅢ级切除）。11例术后随访3个月～6年,平均2.3年,〈1年恢复正常工作和生活9例,术后2年肿瘤复发1例,1年后恢复生活自理1例。结论内镜辅助下眶上锁孔入路切除鞍结节脑膜瘤克服了显微镜直视下的盲区,并发症少,创伤小,效果满意。

Neuroendoscopic-assisted Microsurgery through the Supraorbital Keyhole Approach for Tuberculum Sellae Meningiomas

Objective To summarize our experience on surgical efficacy and skills of neuroendoscopic-assisted microsurgery through the supraorbital keyhole approach for the treatment of patients with tuberculum sellae meningiomas.Methods Thirteen patients with tuberculum sellae meningiomas received partial resection through the supraorbital keyhole approach,and then underwent neuroendoscope-assisted microsurgery to remove the remainder of the tumor.Results The tumor was totally resected in 12 cases（SimpsonⅠ grade resection in two,Simpson Ⅱ grade in 10）and subtotally resected in one（Simpson Ⅲ grade resection）.Eleven of the patients received an follow-up ranged from three months to six years（mean,2.3 years）;nine of them resumed physical and sporting activities,and returned to normal life in one year;one patient showed recurrence in 2 years;and the other one resumed the ability of daily life in one year.Conclusions Neuroendoscopic-assisted microsurgery through the supraorbital keyhole approach can overcome the blind area in direct surgical vision under microscope,and thus effectively improves the total resection rate,diminishes tissue trauma,and decreases the rate of postoperative complication.