锁孔显微神经外科手术治疗颅底和脑深部肿瘤

目的　探讨锁孔显微神经外科手术治疗颅底及脑深部肿瘤的手术技巧和适应证。方法　对 2 5例颅底及脑深部病变行锁孔开颅显微神经外科切除术 ,其中部分使用内窥镜及术中超声辅助技术。结果　 2 2例实体瘤全切除 (或等体积切除 ) 1 9例 ,次全切除 3例 ,无手术死亡、致残及开颅术相关的并发症。结论　锁孔神经外科显微手术是治疗颅底和脑深部病变的微创治疗技术 ,恰当选择适应证、个体化设计手术方案尤其重要 ,神经内窥镜、术中超声的应用可提高手术疗效。

KEYHOLE MICIONEUROSURGERY FOR INTRACRANIAL TUMOR IN DEEP AND SKULL BASE:A REPORT OF 25 CASES

Objective To study the operation techniques and indications of keyhole microneurosurgery used for lesions in depth of brain or skull base. Methods 25 cases of lesions in depth of brain or skull base were treated by microsurgery with keyhole craniotomy,and some of whom were treated with endoscope-assisted microsurgery and intraoperation-ultrasonic sector scan. Results 20cases of solid lesions were totally removed,and 2 cases subtotally removed. There was no associated morbidity, mortality or complication related to craniotomy. Conclusion Keyhole microneurosurgery is a strategy of minimally invasive techniques to deal with the lesions in depth of brain or skull base, however, it is important to choose indication properly and design the strategy individually, in the mean time, application of neuro-endoscope and intraoperation-ultrasonic sector scan can raise the effect also.