扩大经额硬膜外入路切除巨大侵袭性垂体瘤

目的:探讨采用扩大的经额硬膜外入路切除巨大侵袭性垂体瘤的临床应用.方法:1997年6月至2002年3月采用该入路显微外科切除巨大侵袭性垂体瘤10例,肿瘤主要累及于鞍上、蝶筛窦及上斜坡区.结果:本组10例中,肿瘤全切6例,次全切除3例,大部分切除1例.术后发生颅神经麻痹4例,其中动眼神经障碍3例,外展神经障碍1例.全组无手术死亡.术后影像学随访6～24个月,全切除肿瘤病例未见肿瘤复发,次全切除者无明显增大.结论:该入路可充分显露鞍区肿瘤,术野开阔,对脑组织损伤小,适用于已侵犯蝶筛窦区及上斜坡的侵袭性垂体瘤.

Extended subfrontal extradural approach for removal of giant invasive pituitary adenomas

Objective:To remove giant invasive pituitary adenomas by extended subfrontal extradural approach.Methods:The extended subfrontal extradural approach was used in 10 patients with giant invasive pituitary adenomas between Jun. 1997 and Mar. 2002.Tumors were mainly located at surpsella,ethoidal sphenoid sinus,and sphenoid clival regions.Results:Total tumor removal was achieved in 6 cases,subtotal removal in 3 case,and great partial removal in 1 case.Four patients had post operative complications;no surgical mortality occurred.Conclusion:The advantages of extended subfrontal extradural approach is wider exposure and less brain retraction,and it is the most effective method to resect ethoidal sphenoid and tumor involving clival regions.