额颞颧入路海绵窦眶尖肿瘤切除及脑神经保护

目的探讨海绵窦眶尖肿瘤显微手术及脑神经保护的方法。方法回顾性分析8例海绵窦眶尖肿瘤临床资料,均采用额颞颧入路显微神经外科手术切除肿瘤及神经电生理检测保护脑神经,术后定期随访。结果肿瘤全切除4例,次全切2例,大部分切除1例,活检1例。脑神经继发损伤症状出现率22%,脑脊液漏1例,无脑内感染及死亡病例。结论掌握海绵窦眶尖区解剖及熟练的显微神经外科技术,再加上神经电生理检测保护脑神经,可提高肿瘤切除程度,减少脑神经继发损伤。

Microsurgical treatment of fronto-tempo-zygomatic approach to the tumors in the cavernous sinus and orbital apex region and protection of cranial nerve

Objective To discuss the microsurgical methods treating the tumors in the cavernous sinus and orbital apex region and protection of cranial nerve.Methods The clinical data of 8 patients treated by microsurgical operations with fronto-tempo-zygomatic approach and protection of cranial nerve with intraoperative monitoring were retrospectively analyzed.Results Total resection of tumors was attained in 4 cases,sub-total resection in 2 cases,partial resection in one case,and biopsy in one case.The incidence of nerve damages was 22%.Leakage of cerebrospinal fluid was in one patient.Neither infection nor mortality happened.Conclusion Mastering the anatomy of the cavernous sinus and orbital apex region and the skilled microneurosurgery technology,in addition to protection of cranial nerve with intraoperative monitoring may enhance excision degree of the tumor and reduce the incidence of nerve damages.