视神经鞘脑膜瘤的显微外科治疗(附13例报道)

目的探讨视神经鞘脑膜瘤的显微神经外科手术方法。方法收治13例视神经鞘脑膜瘤，根据肿瘤位置采用3种不同经颅入路：单侧额部入路、经额经眶上缘入路及经额颧经眶上缘入路，利用显微外科技术安全显露眶上裂外侧部、眶上裂中央部切除肿瘤。结果肿瘤全切11例，部分切除2例。术后13例患者的眼球突出均恢复正常，11例其它症状和体征也恢复或改善。术后动眼神经麻痹1例，患侧眼失明2例。结论熟悉显微神经外科解剖学，利用显微外科技术选择合适的经颅入路，可以提高视神经鞘脑膜瘤的全切除率，并使颅眶区的正常结构得到最大程度的保护。

Microneurosurgical treatment of the optic nerve sheath meningioma: report of 13 cases

Objective To introduce our approaches and techniques d esigned for operations on optic nerve sheath meningioma.Methods Thirteen cases of optic nerve sheath meningioma treated by transcranial approach were retrospectively analysed. According to the size and the location of the tumor,we chose one of threetranscranial approaches to remove tumor:(1)mo nolateral frontal approach;(2)transorbitorimal-subfronta approach;(3)transorbito rimal-subfrontal-trans zygomal approach,exposed tghe lateral and central part of superior orbital fissur by using microsugical technique during the operation. Results Total removal was achieved in 11 cases and subtotal removed in 2 cases reduction in protosis was noted in 13 cases;Other symptom wa s relieved or disappeared in 11 cases,Postoperatively,oculomotor nerve palsy was found in 1 cses and homolateral blindness occurred in 2 cases.Conl usion We consider that chosing a suitable transcranian approaches by using microsugical technique resulting from familiarity with the microneurosu rgical anatomy is the key to increasing total removal rate and max-protecting th e momal structure in cranio-orbital region.