显微外科治疗颅眶沟通肿瘤

目的分析颅眶沟通肿瘤显微外科治疗的手术方法和治疗效果。方法回顾分析过去5年采用显微手术治疗35例颅眶沟通肿瘤的临床资料。分别采用4种经颅入路、4种经颅开眶入路及3种眶内入路。结果35例肿瘤全切除18例，次全切除13例，大部分切除4例，无手术死亡及严重并发症。结论(1)应根据肿瘤大小、位置和侵袭范围采用不同入路，在充分暴露和直视下广泛切除颅眶沟通肿瘤；(2)熟练的解剖知识及手术技巧、恰当的手术入路、成功的手术切除和及时处理术后并发症等是治疗的关键；(3)颅底缺损应给予修补和重建，硬膜的严密修复是避免脑脊液漏及颅内感染的关键问题。

Microsurgical treatment of cranio-orbital tumors

Objective To analyze the microsurgical methods and therapeutic efficacy of the cranio-orbital tumors. Methods The retrospective analysis was performed in the 35 patients treated microsurgically in the past 5 years, whose surgical approaches involved 4 kinds of transcranial ones, 4 kinds of transcranio-orbital ones and 3 kinds of intraorbital ones. Results Total resection of tumors was attained in 18 cases, subtotal resection in 13 cases, partial resection in 4. Neither mortality nor serious complications happened. Conclusion (1) Different approaches are applied based on the tumor's location, size and invading range for the purpose of fully exposing the cranio-orbital tumors to be extensively resected in straight view. (2) Anatomic knowledge, operative skills, appropriate approaches, successful resection of tumors and timely management of postoperative complications are all crucial for the treatment. (3) During the course of mending and reconstructing the defected skull base, the close suture of the dura is the key to prevent the cerebrospinal fluid leak and intracranial infection.