鞍结节脑膜瘤的鉴别诊断及显微手术技巧

目的探讨鞍结节脑膜瘤鉴别诊断和显微外科手术技巧。方法回顾分析32例鞍结节脑膜瘤的手术,肿瘤大小2~6 cm,所有患者均有视力障碍,其中25例为非对称。手术均采用翼点经侧裂入路。结果25例获肿瘤全切除,7例次全切除。术后视力改善16例,无变化10例,视力减退6例。CT、MR增强有助于鞍结节脑膜瘤与鞍上其他肿瘤的鉴别。结论诊断和治疗鞍结节脑膜瘤仍较困难,肿瘤与正常神经组织之间的蛛网膜屏障是手术的关键,严格地在其间分离使全切除肿瘤成为可能。

Differential diagnosis and microsurgery for tuberculum sellae meningioma

Objective To explore differential diagnosis and therapeutic effectiveness of microsurgery for tuberculum sellae meningioma.MethodsThe clinical data of 32 cases with tuberculum sellae meningioma were analyzed restrospectively.The diameter of meningioma was 2~6cm.All the patients were present with visual acuity deterioration.25 patients were present with unilateral visual acuity.All cases underwent tumor resection by a pterional route.Results25 patients achieved total resection of the tumors and subtotal of 7 patients.Visual acuity was improved in 16 patients,unchanged in 10 patients and worse in 6 patients.Radiological investigations including enhanced computed tomography and magnetic resonance imaging were helpful to distinguish other tumor origining from the neighboring region.ConclusionThe diagnosis and treatment of tuberculum sellae meningioma remain difficult.It is a key to operation keeping arachnoid between the tumor and neighboring normal struction,and it was possible to reset total tumor.