经颅底扩大翼点入路切除颅底肿瘤

目的:经颅底扩大翼点入路开颅术是将翼点开颅术向颅底方向的进一步扩大,包括眶上翼点入路、颧弓翼点入路和眶翼弓入路。本文探讨该入路的手术方法和适应证。方法:经扩大翼点入路切除颅底肿瘤30例。观察术中显露情况及手术效果,并就该入路的手术方法和适应证进行探讨。结果:所有病例术中病灶显露良好,无1例出现脑牵拉损伤。肿瘤全切除25例,次全及大部分切除5例。术后死亡1例,其余病例均无严重并发症。结论:经扩大翼点入路切除颅底肿瘤具有显露好、脑牵拉轻的优点,适用于中颅底、鞍旁肿瘤、颅眶沟通瘤及部分自中颅底向后颅底或颅外生长的肿瘤。

Transbasal Extended Pterional Approach Craniotomy for Cranium Base Tumors

Objective: To investigate the surgical skills and indications of transbasal extended approach craniotomy (including supraorbito- pterional approach, transzygomatic approach and orbitozygomatic approach. )Methods:Thirty patients with skull base tumors were treated via transbasal extended pterional approach. The improved exposure offered by this approach and the results were evaluated. Results: An excellent exposure of lesions was achieved in all cases and no brain retraction injury ensured. Total removal of tumor was achieved in 25 cases,subtotal or partial removeal in 5. All patients had a good recovery without severe complications except one patient who died of acute renal failure 15 days after operation. Conclusion: Transbasal extended pterional approach craniotomy offers a wide angle of exposure for the management of lesions involving anterior and middle cranial fossae, orbit, parasellar region and upper clivus, and intracranial lesions expanding to the infratemporal fossae.