伴有视力障碍的内侧型蝶骨嵴脑膜瘤治疗及预后分析

目的探讨伴有视力障碍的内侧型蝶骨嵴脑膜瘤的手术治疗及术后视力改善情况。方法回顾性分析我院手术治疗的32例伴有视力障碍的内侧型蝶骨嵴脑膜瘤患者临床资料及术后随访结果。结果32例内侧型蝶骨嵴脑膜瘤患者，视力改善20例，未改善12例；肿瘤全切21例，次全切除8例，大部切除3例。术前有视神经萎缩的8例患者，术后随访6例视力无变化，2例视力恶化。小型肿瘤手术后视力改善（改善率90．0％）优于肿瘤较大者（大型及巨大型50．0％）；肿瘤全切的患者视力改善（改善率81．0％）优于未行全切者（改善率27．3％）。结论手术后视力改善与术前肿瘤大小、是否全切及术前有无视神经萎缩有关。

Treatment and prognosis of medial sphenoid ridge meningioma associated with visual impairment

Objective To discuss the surgical treatment and postoperative improvement in visual acuity of medial sphenoid ridge meningiomas associated with visual impairment. Methods The clinical data and the followup results of 32 cases of medial sphenoid ridge meningiomas associated with visual impairment in our hospital were retrospectively analyzed. Results Of 32 cases, 20 cases got improvement in visual acuity and 12 cases remained unchanged. Tumor gross total resection was achieved in 21, subtotal in 8, and large partial in 3. In 8 cases with preoperative optic atrophy, 6 cases remained unchanged in visual acuity postoperatively and 2 cases got deterioration. Improvement of visual acuity in small size tumors was better （ improvement rate of 90.0% ） than that of great size tumors （improvement rate of 50. 0% ）. Improvement of visual acuity in gross total resection was better （ improvement rate of 81.0% ） than that of subtotal resection （ improvement rate of 27. 3% ）. Conclusion The improvement of visual acuity of the medial sphenoid ridge meningiomas is associated with the size of tumor, resection extent and the presentation of optic atrophy.