经额外侧入路手术治疗鞍区中线病变

目的探讨经额外侧入路手术治疗鞍区中线病变的临床疗效。方法1999年10月～2003年4月经额外侧入路施行显微外科手术治疗鞍区中线部位病变患者128例,其中垂体腺瘤57例、颅咽管瘤34例、鞍结节和蝶骨平台脑膜瘤15例、前床突脑膜瘤6例、拉克囊肿4例以及其它病变12例。结果128例患者手术后恢复良好,未发生颅内感染,无严重神经功能障碍,无一例死亡。肿瘤全切除者中垂体腺瘤52例(91.2%)、颅咽管瘤30例(88.2%)、鞍结节和蝶骨平台脑膜瘤15例(100%)、前床突脑膜瘤6例(100%)、拉克囊肿4例(100%),前交通动脉动脉瘤3例夹闭顺利。手术所用时间比常规翼点入路缩短20～30min。结论额外侧入路显露鞍区中线部位病变的效果与翼点入路并无差别。

Surgical treatment in midline sellar lesion via lateral frontal approach

Objective To study the curative effects of lateral frontal approach on treatment of midline sellar lesion. Methods One hundred and twenty-eight cases of midline sellar lesion were treated microsurgically via lateral frontal approach during October 1999-April 2003. Of these cases there were 57 pituitary adenoma, 34 craniopharyngioma, 15 meningioma of sellar tuberculum and sphenoidal planum, 6 meningioma of anterior clinoidal process, 4 Rathke's pouch cyst and 12 other lesions. Results All of the 128 patients had good recovery without infections and severe neurological deficits or death. Total resection of tumor was achieved in 52 cases with pituitary adenoma (91.2%), 30 with craniopharyngioma (88.2%), 15 with sellar tuberculum and sphenoidal planum meningioma (100%), 6 with anterior clinoid process meningioma (100%), 4 with Rathke's pouch cyst (100%), and 3 cases with aneurysm of anterior communication artery were clipped successfully. The operation time with lateral frontal approach is shortened about 20-30 min than that with the pterion approach. Conclusion The effect of exposing lesions in midline sellar by lateral frontal approach is similar to that by pterion approach without any differences.