147例颅底中央区脑膜瘤的显微手术疗效分析

目的 探讨颅底中央区脑膜瘤的手术治疗策略和方法.方法 收集147例颅底中央区脑膜瘤患者,根据肿瘤部位和生长方向不同,分别选择额下入路、翼点人路、枕下乙状窦后入路、颞下经小脑幕入路、乙状窦前幕上下联合入路、远外侧入路等予以显微手术切除,对手术方法和疗效进行回顾性分析总结.结果 Simpson Ⅰ、Ⅱ级切除112例,Ⅲ级32例,Ⅳ级3例.1例术后颅内感染.30例脑神经功能较术前改善,25例脑神经功能障碍较术前加重或出现新的神经功能损害.结论 个体化的手术方案,显微手术操作能提高颅底中央区脑膜瘤的全切除率和手术疗效.

Results of microsurgical removal of 147 central skull base meningiomas

Objective To investigate the strategy and techniques of microsurgical treatment for central skull base meningioma. Methods A retrospective review was performed in 147 central skull base meningiomas, which were admitted consecutively from April 2004 to December 2007, and were removed via subfrontal approach, pterional approach, suboccipital retrosigmoid approach, subtemperal transtentorial approach, presigrnoid supra- and infratentorial approach and far lateral approach depending on the position and the extension of the tumors. Results The tumors were totally resected ( Simpson Ⅰ , Ⅱ ) in one-stage in 112 cases. The function of cranial nerves was improved in 30 cases. There were new functional deficits or deterioration of cranial nerves in 25 cases. There was no operative mortality. Contusion Despite of the challenges encountered in treating complex central skull base meniugiomas, precise preoperative evaluation, tailored surgical approaches according to tumor extension and microsurgical techniques can serve two purposes: total resection and minimal morbidity.