巨大内侧型蝶骨嵴脑膜瘤的外科治疗

目的 探讨巨大内侧型蝶骨嵴脑膜瘤显微手术治疗的经验.方法 回顾性分析26例巨大内侧型蝶骨嵴脑膜瘤的临床资料,肿瘤直径5.5～8.5 cm,均采用改良翼点入路.结果 Simpson Ⅰ～Ⅱ级切除17例,Ⅲ级切除7例,Ⅳ级切除2例.动眼神经麻痹8例,其中3个月后恢复4例,未恢复4例.术后偏瘫转康复治疗4例,无死亡病例.结论 对于巨大的内侧型蝶骨嵴脑膜瘤,术前详尽阅片、术中控制出血及保护重要结构对手术疗效非常重要,肿瘤全切后病人预后较好.

Surgical treatment of giant medial sphenoid ridge meningioma

Objective To analyze the explore the experience of microsurgery for giant medial sphenoid ridge meningioma.Methods The clinical data of 26 patients with giant medial sphenoid ridge meningioma were analyzed retrospectively.The diameter of tumor was 5.5-8.5cm.Allthepatientsreceivedsurgeryviamodifiedpterionalapproach.Results AccordingtoSimpsoncriteria,gradeⅠ-Ⅱ resection was achieved in 17 cases,grade Ⅲ in 7 and grade Ⅳ in 2.Eight patients suffered oculomotor nerve palsy after the surgery,4 of them recovered after 3 months,but the other 4 did not recover.Four patients suffered hemiplegia after the surgery and then received rehabilitation therapy.No death occurred.Conclusions For giant medial sphenoid ridge meningioma,it is very important to read images minutely before surgery,limit intraoperative hemorrhage and protect important structures for surgical outcome.Patients receiving total tumor resection could have a more favorable prognosis.