额颞眶颧入路切除颅中窝底肿瘤

目的 探讨额颞眶颧入路的特点及其切除颅中窝底肿瘤的手术技巧和适应证。方法 本入路是将额颞开颅颅骨切除的范围扩大到包括眶上缘、眶外测壁及颧弓，以增加肿瘤的暴露，有利于肿瘤的切除。采用该方法对２２例颅中窝底肿瘤进行手术，取得良好效果。其中脑膜瘤９例，垂体瘤８例，神经鞘瘤２例，脊索瘤２例海绵状血管瘤１例。结果 获得肿瘤全切除１３例，次全切除６例，大部分切除３例，无手术死亡和严重手术并发症结论 初步手术

Surgical Excision of Tumors in the Middle Cranial Base Via Frontotemporal Obito-zygomatic Approach

Objective To evaluate the characteristics, the indications of frontotemporal obito-zygomatic approach, and the operative skills for removing middle cranial base tumors. Methods Data from 22 patients with the middle cranial base tumors, who were operated via frontotemporal obito-zygomatic approach, was analysed reerospectively. During the operation, en bloc osteotomy including the superior and lateral orbital rims and zygomatic arch was performed together with the fronto-temporal craniotomy. Histo-logical diagnosis was meningioma in 9, pituitary adenoma in 8, neurinoma in 2, chordoma in 2 and cavernous angioma in 1. Results In this series of patients, total removal of tumors was achieved in 13 cases, subtotal in 6 and partial in 3. There was no operative mortalily and no serious complication occurred after the surgery. Conclusions The authors summarized the advantages of this approach as follows: (1)To provide better exposure of the tumor and a lower operative field plane for the surgery than the traditional approach, making the access easier to lesions located in the vicinity of the skull base with minimal or even without cerebral retraction; (2)It may be helpful to exposing the tumor in different directions especially those which had involved both the intra-and extra-cranial or dural space.