经眶上锁孔入路切除鞍区肿瘤的手术要点探讨

26例鞍区肿瘤患者均经眉弓切口，做眶上小骨窗，在显微镜及内窥镜下分块切除肿瘤。肿瘤全切除53．8％（14／26），次全切38．5％（10／26）。术前有视力障碍的22例，20例术后改善。无手术入路相关的并发症，手术效果满意。认为经眶上锁孔入路骨窗小，对脑组织损伤轻，肿瘤暴露好，控制范围广，是较为理想的鞍区手术入路，但对术前影像学、手术设备及显微操作有较高要求。

Surgical experience with supraorbital keyhole approach to sellar areatumor

To develop a new supraorbital keyhole approach,26 patients with sellar area tumors were selected Supraorbital craniotomy was made with eyebrow incision Tumors were resected under microscope and assisted with endoscope Total resection were performed in 53 8%(14/26) and subtotal resection in 45 55(10/26) of the patients Among the 22 patients with impaired visual acuity, 20 obtained partial or complete recovery No approach related complication was observed These suggested that the supraorbital keyhole approach offers good exposure of sellar area tumors and wide range of control, with smaller craniotomy, less cosmetic problems and less invasion to brain tissue But preoperative images with high quality, advanced equipments and experienced microsurgical skill are required