翼点入路显微手术切除巨大复杂颅咽管瘤8例

目的探讨鞍区5个间隙在巨大复杂颅咽管瘤全切手术中的意义。方法在手术显微镜下经翼点人路鞍区5个解剖间隙切除鞍区肿瘤8例,术中注意保护肿瘤周围的视神经、颈内动脉及发出的垂体上动脉。结果8例鞍区肿瘤,全切除7例(87.5%),大部切除1例,复发1例(12.5%)。结论翼点人路行鞍区肿瘤的显微手术中,熟练掌握鞍区5个解剖间隙及垂体血供的显微解剖,是提高全切率、降低死亡及复发率的关键。

Microsurgical removal of 8 cases of large craniopharyngiomas through pterion approach

Objective To explore the significance of the 5 anatomical spaces in saddle area in operation of total removal of large and complicated craniopharyngiomas.Methods Guided by the operating microscope,the craniopharyngiomas in 8 patients were resected through the 5 anatomical spaces via pterion approach.Important structures including the optic nerve and internal carotid artery(ICA)and it's arteriae hypophysialis superior were paid attention.Results Among eight cases of sellar tumour,seven cases(87.5%) were performed with total resection,one case was performed with subtotal resection and one case(12.5%) recurred.Conclusion In microsurgical removal of large craniopharyngioma via pterion approach,a skillful grasp of five anatomical spaces and microanatomy of blood supply of appendices suprasphenoidalis,which plays an important role in improving the rate of total resection ,decreasing mortality and recurrence.