小儿颅咽管瘤的显微手术治疗

目的探讨小儿颅咽管瘤显微手术全切除的入路和方法。方法26例经显微手术切除的颅咽管瘤中,囊性15例,实质性11例;有钙化者13例;肿瘤直径2cm以下者2例,2～4cm10例,4.1～6cm11例,>6cm者3例。经右翼点入路切除肿瘤22例,经胼胝体前入路3例,经胼胝体-翼点联合入路1例。结果经术中观察和影像学资料证实,全切除23例,次全切除2例,大部切除1例。随访2个月～5年,恢复正常生活并参加学习者22例,需人照顾者4例。结论小儿颅咽管瘤早期诊断并行显微手术全切除,治疗效果理想;翼点入路是小儿鞍区颅咽管瘤显微手术切除的最佳入路。

Microsurgical treatment for children craniopharyngiomas

Objective To explored the method and approach of radical treatment for children craniopharyngiomas. Methods 26 children patients with craniopharyngiomas were operated by microsurgical resection, cystic change of the tumors were found in 15 patients, calcification tumor tissue in 13 patients and solid tumor in 11 patients. The size of the tumor: < 2 cm in 2 cases, 2.1-4 cm in 10 cases, 4.1-6 cm in 11 cases, > 6 cm in 3 cases. 22 patients were operated via the right pterional approach, 3 via transcallosal approach, 1 via combined transcallosal-pterional approach. Results Total removal of tumors were achieved in 23 cases, and subtotal removal in 2 cases, greater part removal in 1 case. All patients were followed-up from 2 months to 5 years. 22 patients recover to normal life and study, 4 patients need assisted in life. Conclusion Early diagnosis, at a stage when the tumor is still small, performs radical removal and achieves good operative result. The pterional approach may be the best way for total removal of children craniopharyngiomas, except the tumor grows into third ventricle.