视神经管开放减压在前颅底病变处理中的应用

目的 探讨视神经管开放减压在前颅底病变中的应用.方法 神经减压的手术入路除鞍结节脑膜瘤的4例采用额颞硬膜下入路外,其他均采用经颅额下外侧硬膜外入路.视神经管减压的应用病例包括外伤后急性视神经损伤7例,其中6例外伤后视力完全丧失,1例仅留光感;骨纤维异常增殖症8例;视神经及其周围组织肿瘤(围视神经肿瘤)包括颅眶海绵窦沟通...

Optic Canal decompressions for anterior skull base surgery

Objective To explore the usefulness of optic canal decompressions in anterior skull base surgery. Methods 26 patients undergoing optic canal decompressions between 1995 and 2009 were identified. 22 decompressions were performed via a lateral subfrontal extradural approach and four patients via a fi＇onta-temporal subdural approach. The group include 7 acute optic nerve injmy, 8 fibrous dysplasia, 4 tuberculum sellae meningiomas and 5 crania-orbital communicated schwannomas, 1 haemangiopericytoma of optic canal, 1 lymphoma of anterior skull base. Visual acuity and fields were recorded pre-operatively, post-operatively. Results Only two patients experienced improvements in acute optic nerve injury after operation, either acuity or field, the rest 5 patients＇ visual acuity unchanged. Five patients＇ visual acuity improved, 2 unchanged and 1 deteriorated. The visual acuity improved to some extent in patients with tuberculum sellae meningiomas and crania-orbital communicated schwannomas. The visual acuity lost in patient with haemangiopericytoma. The patient with lymphoma experienced post-operative visual acuity improvement. Conclusions Optic nerve decompression from extradural approach is a safe and effective method. Frontal lobe injury is minimal. Choice of suitable eases can get an excellent outconle.