不同入路手术治疗鞍区脑膜瘤(附30例分析)

目的总结鞍区脑膜瘤的手术经验。方法回顾性分析30例鞍区脑膜瘤的临床资料。根据CT和MRI测量的肿瘤最大径分型:小型(<3cm)8例,中型(3～5cm)15例,大型(>5cm)7例。采用4种不同的手术入路(眶上锁孔、翼点锁孔、单侧额下和Yasargil标准翼点入路)切除肿瘤,比较手术结果和术后恢复情况。结果肿瘤全切除24例,次全切除6例。术后恢复良好者23例,生活自理4例,无法自理2例,死亡1例,病死率3.3%。18例有视力障碍者中,改善10例,无改善7例,减退1例。结论锁孔入路适用于位置深在的鞍区脑膜瘤手术;标准翼点入路适用于基底宽广,跨颅前、中窝的大型脑膜瘤。合理选择手术入路并恰当运用显微手术技术,是安全和完全切除肿瘤的关键。

The different approaches of surgical treatment for sellar region meningeoma: analysis of 30 cases

Objective To summarize the surgical experience with sellar region meningeoma. Methods The 30 cases of sellar region meningeoma were analyzed retrospectively. Based on the maximal diameter of tumor on CT or MRI, the tumors were classified into small (<3 cm) in 8 cases, middle (3-5 cm) in 15 and large ( > 5 cm) in 7. The tumors were removed by four different surgical approaches, including supraorbital keyhole, pterional keyhole, unilateral subfrontal and Yasargil s standard pterional approach, and the s...