蝶骨嵴内1/3脑膜瘤的显微外科治疗技术

报告36例蝶骨嵴内1／3脑膜瘤的手术治疗效果，其中5例肿瘤已包裹颈内动脉及其分支，肿瘤全切率达100％，无手术死亡及病残,术后神经系统体征均有好转。手术采用翼点入路，在硬脑膜下切除肿瘤，先探查肿瘤基底，以双极电凝阻断其血供，再行囊内分块切除肿瘤。对于肿瘤已包裹颈内动脉者，先从其远端找到肿瘤与血管的界限，按其解剖平面，细致地将肿瘤分离下来，分块切除。手术的疗效取决于充分的术前准备，熟练应用显微外科技术，特别是双极电凝的使用技巧，以及良好的手术入路。

Microsurgical Treatment of Inner 1/3 Sphnoid Meningioma

36 cases of total resection of sphnoid meningioma were studled. In 5 cases, the ICA was wrapped by the tumor. The total resection rate in this group reached 1 00 %. No mortality nor post-operative deterioration occurred. Pre-oporative neurologic defects were improved. Fterional approach was apllied in the operation. The tumor was resected subdurally. Bi-coagulation was iniliallly used to dissect the tumor base and cut the blood supply of the tumor, then intra-capsule rernoval was carried out. For those in which ICA was encapsuled in the tumor, dissection plane should be identified at distal end of the vessel. The outcome of these patients depends on good preparation before the operation, skillful microsurgical technique, especically the use of bi-polar coagulation and an appropriate approach of the operation.