显微手术治疗鞍结节脑膜瘤

目的探讨鞍结节脑膜瘤的手术入路和治疗策略.方法回顾性分析32例鞍结节脑膜瘤的临床资料,其中经单侧额下入路6例,经额外侧入路9例,经翼点入路8例,经额下-纵裂入路9例.结果肿瘤达SimpsonⅡ级切除26例,SimpsonⅢ级切除6例.失访3例,29例随访3～60个月,平均18.5个月.9例术前激素水平低下者术后均恢复正常.病人恢复正常工作和生活25例,不能独立生活4例.肿瘤复发2例.结论根据肿瘤大小和不同的生长方式选择恰当的手术入路,同时保护好鞍结节周围的重要结构,是获得良好手术效果的保证.

Microsurgery for tuberculum sellae meningiomas

Objective To explore the surgical approaches and strategy for removing tuberculum sellae meningiomas. Methods Clinical data of 32 patients with tuberculum sellae meningioma undergoing microsurgery were analyzed retrospectively, and the surgical approaches included unilateral subfrontal in 6 patients, lateral transfrontal in 9, pterional in 8, subfrontal-interhemispheric fissure in 9. Results Simpson grade II resection was achieved in 26 patients and Simpson grade 111 resection in 6. Three patients were lost to follow-up, and 29 patients were followed up for mean time of 18.5 months, ranging from 3 to 60 months. Nine patients with poor hormone levels returned to normal after surgery. Additionally, normal work and life was noted in 25 patients, without self-care ability in 4 and tumor recurrence in 2. Conclusions Selecting the appropriate approach according to the tumor size and growth and protecting the major structures near the tuberculum sellae can assure an effective surgery.