经颅眶入路治疗眶尖部肿瘤

目的总结经颅眶入路治疗眶尖部肿瘤时保存视神经、眼动脉、动眼神经等血管神经的方法。方法回顾性分析69例经颅眶入路治疗眶尖部肿瘤病人的临床资料。其中良性肿瘤62例,恶性肿瘤7例。采用经颅眶入路切除肿瘤,所有手术均由神经外科、眼科医师共同完成。结果肿瘤根治性切除60例,部分切除9例;术后4例动眼神经损伤,仅1例视神经、动眼神经、展神同时损伤。结论掌握眼科解剖学知识和神经外科显微操作是进行眶尖部肿瘤切除手术的基础。行经颅眶入路,在眶尖部骨性充分减压后先分离切除肿瘤前部,是保护视神经、眼动脉、动眼神经的有效方法。

Transcranial orbital approach to the tumors of orbital apex

Objective To discuss the methods for preventing orbital apex structure injury from operations via transcranial orbital approach. Methods Sixty-nine patients with orbital apex tumors were retrospectively analyzed. Tumors were benign in 62 cases, and malignant in 7. Tumors were resected via transcranial orbital approach. All the operations were performed by neurosurgeions and oculists. Results Radical resection was performed in 60 patients and partial resection in 9. After the operation, oculomotor nerve injury occurred in 4 cases, and oculomotor plus optic nerve injury occurred in 1. Conclusions Combination of the anatomic knowledge and neurosurgical manipulation is the base for resection of orbital apex tumor, and dissecting and resecting the tumor in pieces from anterior to posterior via transcranial orbital approach after decompressing bony structures of orbital apex is an effective procedure for preservation of nerves and vessels of orbital apex.