眶颅沟通性肿瘤的诊断和手术治疗

目的：探讨眶颅沟通肿瘤的临床特征、种类、诊断方法及手术治疗。方法：选择60例手术病理或随访结果证实的眶颅沟通肿瘤患者，所有患者均行CT扫描，54例行MRI扫描，其中增强扫描42例。20例行视神经管X光像。经翼点入路切除肿瘤12例，经额入路切除肿瘤21例。结果：最常见的阳性体征是眼球突出、眶压升高和视力下降等，最常见的症状是头痛。较多见的眶颅沟通肿瘤是脑膜瘤、骨纤维异常增生症和转移癌。眶颅沟通肿瘤的CT、MRI扫描及视神经孔X光像有一定影像学特征。眶颅沟通的途径包括视神经管、眶上裂和眶颅交界骨壁。全切肿瘤32例，次全切肿瘤1例。结论：掌握各种眶颅沟通肿瘤的临床特征、病种分类，综合运用CT、MRI和X光等检查方法可提高诊断和鉴别诊断水平。翼点入路和经额入路是眶颅沟通肿瘤的重要手术方法。

Diagnosis and surgical approach of orbito-cranial communicating tumors

objective:to investigate the clinical features,pathological types,diagnostic methods and surgical approaches of orbito-cranial communicating tumors.methods:60 cases of orbito-cranial communicating tumors confirmed by pathology and follow-up results were studied.ct was performed in all 60 cases and mri in 54 cases.post-contrast mri was completed in 42 cases.x-ray of optic canal was performed in 20 cases.removal of orbito-cranial communicating tumor by two approaches:pterional approach was done in 12 patients,transfrontal craniotomy in 21 patients.results :the most common symptoms were proptosis,increase of orbital pressure and loss of sight;the most common sign was headache.meningomas,fibrous dysplasia and metastasis carcinomas were more popular in orbito-cranial communicating tumors.different kinds of orbito-cranial communicating tumors had specific imaging features in ct,mri scan and x-ray.communicating passages of tumors included optic canal,superior orbital fissure and bone walls between the orbital cavity and the cranial cavity.total remmoval of tumors were achieved in 32 cases,and subtotal removal in one case.conclusion:it is very helpful for diagnosis and differential diagnosis of orbito-cranial communicating tumors that comprehending the category and clinical features,applying several kinds of imaging methods including ct,mri and x-ray.pterional and transfrontal approaches are important surgical ways for orbito-cranial communicating tumors.