翼点入路显微手术切除巨大型鞍结节脑膜瘤

目的总结经翼点入路显微手术切除巨大鞍结节脑膜瘤的经验. 方法 2000年2月～2004年11月我院应用显微外科技术,治疗巨大鞍结节脑膜瘤18例.偏侧生长的肿瘤选择翼点入路,先处理肿瘤基底减少血供,再充分利用鞍区脑池及肿瘤与周围结构之间的蛛网膜界面,在保护好重要结构的前提下最大限度地切除肿瘤. 结果全切除16例(88.9%),次全切除2例(11.1%),无一例手术死亡.14例随访3个月～4年,平均2.5年,肿瘤无复发. 结论翼点入路可对中颅窝、鞍区病变进行良好暴露,提高巨大型鞍结节脑膜瘤全切除率.

Pterional approach microsurgical removal of giant tuberculum sellae meningiomas

Objective To summarize the experience of pterional craniotomy microsurgical resection of giant tuberculum sellae meningiomas. Methods A total of 18 patients with giant tuberculum sellae meningiomas were treated microsurgically in this hospital from February 2000 to November 2004. The patients were operated on by use of pterional craniotomy on the side of worse vision. The basal part of the tumor was firstly dissected to control the blood supply of the lesion. Through the cerebral cisterns at the sellar region and the interfaces between the tumor and the adjacent structures, the tumor was removed to the greatest possible extent with minimal invasion to the neighbouring structures. ResultsWTBZ] A total resection was conducted in 16 patients (88.9%), and a subtotal resection, in 2 patients (11.1%). No surgery related death was observed. Follow-up examinations in 14 patients for 3 months ~ 4 years (mean, 2.5 years) found no recurrence of meningiomas. ConclusionsWTBZ] The pterional approach provides excellent exposure of the middle fossa and the parasellar area. Pterional approach microsurgical technique can improve the rate of total resection of giant tuberculum sellae meningiomas.