经眶入路神经内镜手术治疗颅中窝底病变的疗效分析(附17例报道)

目的探讨神经内镜下经眶入路(ETOA)手术治疗颅中窝底肿瘤的疗效。方法回顾性分析2017年6月至2021年3月ETOA手术治疗的17例颅中窝底病变的临床资料。结果术后病理显示脑膜瘤9例,胶质瘤3例,神经鞘瘤2例,淋巴瘤1例,海绵状血管瘤1例,血管外皮细胞瘤1例。肿瘤全切除11例,次全切除5例,部分切除1例。术后出现脑脊液漏2例、短暂性动眼神经麻痹3例、脑梗死1例、颅内大出血1例(再次手术)。出院后随访6~24个月,无死亡病例;1例次全切除胶质瘤术后12个月出现进展,二次手术;其余病例未见复发或进展。术后6个月,改良Rankin量表评分0~2分14例,3分3例。结论 ETOA手术是治疗颅中窝底病变的有效方法,可达到令人满意的切除程度,并有效地减少并发症。

Surgery through endoscopic transorbital approach for patients with middle cranial fossa lesion: report of 17 cases

Objective To explore the clinical efficacy of surgery through endoscopic transorbital approach (ETOA) for the patients with middle cranial fossa lesion. Methods The clinical data of 17 patients with middle cranial fossa lesion who underwent surgery through ETOA from June 2017 to March 2021 were analyzed retrospectively. Results The postoperative pathological examination showed meningiomas in 9 patients, gliomas in 3, schwannomas in 2, lymphoma in 1, cavernous hemangioma in 1 and hemangiopericytoma in 1. Total resection of the tumor was achieved in 11 patients, subtotal in 5 and partial in 1. After the operation, cerebrospinal fluid leakage occurred in 2 patients, transient oculomotor nerve palsy occurred in 3, cerebral infarction occurred in 1, and heavery intracranial hemorrhage (reoperation) occurred in 1. The follow-up (range, 6~24 months) showed tumor progression in 1 glioma patient who received subtotal resection 12 months after the operation, and no recurrence or progression in the other 16 patients. The modified Rankin scale score of 0~2 was achieved in 14 patients and score of 3 in 3 patients 6 months after the operation. Conclusions Surgery through ETOA is an effective treatment for the middle cranial fossa lesions, which can achieve a satisfactory degree of lesion resection and effectively reduce the postoperative complications.