神经内镜辅助眶上锁孔入路治疗巨大嗅沟脑膜瘤

目的探讨神经内镜辅助眶上锁孔入路治疗巨大嗅沟脑膜瘤的手术效果及手术技巧。方法采用内镜辅助、眶上锁孔入路（显微手术）治疗12例巨大（≥7cm）嗅沟脑膜瘤。结果肿瘤全切除9例（SimpsonⅠ级切除5例，Ⅱ级切除4例），次全切除（SimpsonⅢ级切除）3例。无手术死亡。10例随访3个月～2年，平均14个月。9例恢复正常生活，1例生活能自理。NRI随访9例，肿瘤无复发。结论利用神经内镜辅助及显微外科技术，采用眶上锁孔入路、对肿瘤进行分块切除治疗巨大嗅沟脑膜瘤，手术创伤小，疗效满意。

Neuroendoscope-assisted Microneurosurgery via Supraorbital Keyhole Approach for Giant Olfactory Groove Meningioma

Objective To explore the effect and technical skills of neruoendoscope-assisted microneurosurgery via the supraorbital keyhole apporach for giant olfactory groove meningiomas. Methods A total of 12 patients with giant olfactory groove meningiomas （≥7 cm in diameter） received neruoendoscope-assisted microneurosurgery via the supraorbital keyhole approach. Data of the patients were analyzed retrospectively. Results Among the cases, 9 achieved complete resection of the tumor, inlcuding 5 cases of Simpson Ⅰ and 4 cases of Simpson Ⅱ. The other 3 （Simpson Ⅲ ） patients underwent subtotal resection. None of the patients died during the operation. Ten of the patients were follwed up for 3 months to 2 years （mean, 14 months）. During the follow-up, 9 of the 10 resumed physical and sporting activities, and the other one retured to normal daily life. MRI examination was prefomred on 9 patients, none of them had recurrence. Conclusions Neruoendoscope-assisted microneurosurgery via the supraorbital keyhole approach is effective and safe for patient with giant olfactory groove meningioma. The tumor should be removed piece by piece during the operation.