海绵窦肿瘤的诊断和显微手术切除

目的 探讨海绵窦肿瘤的诊断与显微手术治疗效果.方法 38例患者经CT 及MRI诊断为海绵窦肿瘤.采用改良翼点入路、于显微镜下手术切除病变.结果 31例(81.6%)肿瘤达全切除,5例(13.1%)获次全切除,余2例(5.3%)为部分切除,术后1例(2.6%)死亡.术后头痛及海绵窦综合征症状有所改善.肿瘤标本经病理学检查证实分别为脑膜瘤、神经鞘瘤、海绵状血管瘤、垂体腺瘤和胆脂瘤.33例随访8月～12(平均3.6)年,3例肿瘤复发,4例无变化或略有缩小.对其中的4例行放射外科治疗.结论 MRI是诊断海绵窦肿瘤的最佳检查方法,采用改良翼点入路显微手术切除本类肿瘤,效果良好.

Diagnosis and microsurgical removal of cavernous sinus tumors

Objective To probe the diagnosis and the effectiveness of microsurgical treatment for cavernous sinus tumors (CST).Methods Thirty-eight patients with CST had been diagnosed by CT or MRI. The tumors were excised utilizing the improved pterional approach to the cavernous sinus region under operative microscope .Results Total resection was achieved in 31 patients (81.6%), subtotal resection in 5 (13.1%) and partial resection in 2 (5.3%). One patient (2.6%) died after operation. The symptoms such as headache and cavernous sinus syndrome were ameliorated post-operation. All operative samples were confirmed pathohistologically as meningioma, neurinoma, cavernous angioma, pituitary adenoma and cholesteatoma . Follow-up study (ranged from 8 months to 12 years with a mean period of 3 .6 years) was available in 33 patients , the tumor became enlarged in 3 cases, and unchanged or decreased in size in 4 cases, in which 4 cases underwent postoperative radiosurgery.Conclusion MRI examination is the best method for diagnosis of the patients with CST, and these tumors can be removed successfully with the microsurgical technique via the improved pterional approach.