累及眶尖的海绵窦肿瘤的手术探讨

目的讨论累及眶尖的海绵窦肿瘤手术方法及相关解剖。方法22例全部采用额颞弧形切口，翼点人路。当肿瘤位于视神经外侧或海绵窦外侧壁时，选择颞部偏大的切口。取下骨瓣，磨除蝶骨嵴，剪开硬膜，分开外侧裂。依据肿瘤的位置用微钻磨除前床突和视神经管上壁。选择肿瘤突出部位切开海绵窦外侧壁或眶筋膜，分块切除肿瘤。结果22例肿瘤中，17例全切，3例近全切，1例大部分切除，1例活检。结论详细了解海绵窦和眶尖肿瘤的外科解剖是达到其外科切除的良好结果所必需。

Surgery for Cavernous Sinus Tumors Involvling Orbital Apex

Objective To explore surgical methods of the cavernous sinus tumors involving the orbital apex and the relevant anatomical structure. Methods The surgery through pterional approach was performed in 22 patients with cavernous sinus tumors involving the orbital apexes. A sickle-shaped incision was made and the sylvian cistern was opened when the operation was performed. The anterior clinoid process and the upper wall of the optic canal were ground by using a high-speed drill according to the location of the tumor. The lateral wall of cavernous sinus or orbital fascia where the tumor protruded from was incised, and the tumor was removed piece by piece. Results Of the 22 cases of tumors, 17 were totally removed, 3 subtotally, 1 partly and 1 only received biopsy. Conclusion it is necessary for achievement of total resections tumors to know well the microsingical anatomy of the cavernous sinus and orbital apex.