两种不同入路手术治疗海绵窦区肿瘤

目的探讨海绵窦区肿瘤切除的手术入路,以提高手术全切率,降低残障率.方法对14例海绵窦内肿瘤行硬膜下入路切除5例,行硬膜外入路切除9例,比较两种入路的方法及疗效.结果行硬膜下入路者中全切除2例,大部切除3例;术后出现新的神经功能障碍4例.行硬膜外入路者中全切除5例,次全切除3例,大部切除1例;术后出现新的脑神经功能障碍3例,其中1例完全恢复.结论针对不同类型的肿瘤及生长特性,选择适当的手术入路和显微神经外科技术,可有效提高全切率,降低残障率.

Comparison of two different surgical approaches for tumors in cavernous sinus region

Objective To enhance our understanding of microanatomy of the cavernous sinus, increase overall resection rate of cavernous sinus tumors, and improve the neurological dysfunction, Methods Fourteen cases were retrospectively analyzed. The tumors were resected via subdural surgical approach in 5 cases, and via anterior-lateral epidural surgical approach in 9. The procedures and therapeutic effects of the two approaches were compared. Results In the 5 cases via subdural surgical approach, the tumors were totally removed in 2, partially removed in 3, and 4 of the 5 patients had postoperative new cranial nerve dysfunction. In the 9 cases via epidural surgical approach, the tumors were totally removed in 5, subtotally removed in 3, partially removed in one, and 3 of the them had postoperative new cranial nerve dysfunction, one gained complete recovery. Conclusion Choosing appropriate surgical approaches according to the tumor types and growth characteristics, with skilled microneurosurgical technique, overall tumor resection rate and neurological function could be improved effectively.