经改良翼点入路显微外科治疗鞍区肿瘤探讨

目的:探讨复杂鞍区肿瘤的显微外科治疗方法.方法:分析4年来通过显微神经外科技术治疗的56例复杂鞍区肿瘤的临床资料.手术采用改良翼点入路,运用显微外科技术从鞍区的各个手术间隙分块切除肿瘤.结果:33例垂体腺瘤肿瘤全切26例,大部分切除7例;12例颅咽管瘤全切8例,大部切除4例;ll例脑膜瘤全切9例,大部分切除2例,病人术后均神志清楚,6例发生了视神经功能障碍,2例发生了动眼神经功能障碍.结论:改良翼点入路是处理复杂鞍区肿瘤的极佳手术径路.熟练掌握显微神经外科技术和熟悉鞍区的各个手术间隙解剖并能在术中充分利用之是完成复杂鞍区肿瘤切除术的关键.

Treatment of complicated tumors in sellar area with microsurgical techniques:A report of 56 cases

Objective: To investigate the microsurgical techniques for complicated tumors located in sellar area.Methods:The operations were performed by a modified trans-pterion approach,and tumors were removed from spaces in sellar area with microsurgical techniques.Results:Twenty-six of 33 pituitary adenomas,8 of 12 craniopharyngiomas and 9 of 11 sellar meningiomas were totally removed,and the other cases of the three kinds of tumors above were subtotally removed.All the patients were sober after operation.Functional impairment of optic nerves and oculomotor nerves appeared in 6 and 2 patients,respectively.Conclusion:This modified trans-pterion approach is very suitable to remove complicated sellar tumors.Mastering the microsurgical techniques and acquaintance with the anatomy spaces in sellar area are a key to remove complicated tumors in the sellar area.