扩大翼点入路切除前中颅底病灶的临床体会

目的探讨改良的经颅底扩大翼点入路（包括经眶额入路、经颧弓入路和眶颧弓入路）切除前中颅底病灶的优越性和适应证.方法经标准翼点入路11例,眶额入路19例,颧弓入路4例,眶颧弓入路4例.结果病灶全切除33例,次全切除及大部分切除4例,无法处理病灶1例,无一例出现脑牵拉损伤.结论经颅底扩大翼点入路处理颅底病灶比标准的翼点入路显露更好,正常脑组织侵袭性更小.改良的经颅底扩大翼点入路不仅适于前中颅底肿瘤的切除,而且可应用于脑血管病和脑外伤的手术治疗.

Transbasal extended pterional approach in the resection of anterior and middle skull basal lesions

Objective To evaluate the advantages and indications of modified transbasal extended pterional approach including orbitofrontal approach, zygomatic approach and orbitozygomatic approach in the resection of anterior and middle skull basal lesions. Methods 11 patients were treated via standard pterional approach, 19 patients via orbitofrontal approach and 4 via zygomatic approach and 4 via orbitozygomatic approach. Results Total removal of lesion was achieved in 33 cases, subtotal or partial removal in 4, and incurable lesion in 1. No brain stretch injury ensued. Conclusion Modified transbasal extended pterional approach offers a wider view of exposure and less cerebral stretch for the management of lesions involving anterior and middle cranial fossae, compared with standard pterional approach. It may be applied to anterior and middle skull basal tumors, cerebral vascular diseases and traumatic brain injuries.