视神经及视交叉胶质瘤

报告２８例视经济及视交叉胶质瘤，肿瘤局限于一侧视神经４例，累及视交叉２４例。２８例均手术，其中肿瘤切除２５例，活检３例，９３％为星形细胞瘤。术后放射治疗２７例，２６例得到随访。８９％的病人视力好转或维持稳定。术后肿瘤复发２例。手术及放疗可改善视力，减少肿瘤复发，提高生存率。

Gliomas of the optic nerve or/and chiasm

Gliomas of the optic nerve or/and chiasm are relatively infrequent tumor, consitituting approximately 1%to 5%of all gliomas. Twenty-eight patients with optic nerve or/and chiasm glioma have been treated at the Beijing Tiantan Hospital between 1982 to 1992. 93%patients were younger than 20 years old at the time of diagnosis, 50%were younger than 10 years old.All patients have the decreasing of vision,25%patients have incretory disturbance,9%have hydrocephlus,Four patients(14%)had optic nerve gliomas defined as tumors confined to one optic nerve,were treated by total or subtotal excision. Twenty-four patients(86%)had chiasmal gliomas or chiasmal involvement,of the twenty-one patients treated by subtotal or partial resection, three by biopsy followed by irradiation, one patient died in the immediate postoperative period. of 59%patients had preserved vision stable in the postoperative period, all patients were irradiated after surgical excision of the tumor, of the twenty-six patients were followed, 89%patients had preserved or improved vision two had tumor recurrence. In our experience,for tumors confined to one optic nerve,complete surgical resection appears to be adequate, For chiasmal tumor,complete resection is prohibitive and radiotherapy is recommended since it can result in improved vision and decreased tumor recurrence.