鞍结节脑膜瘤的手术入路及显微手术技巧

目的：探讨显微手术切除鞍结节脑膜瘤的手术入路选择和显微外科技巧。方法回顾性分析46例鞍结节脑膜瘤患者的临床资料，46例均应用显微外科技术切除，其中额下入路19例，翼点入路14例，额下-翼点联合入路7例，眶上锁孔入路6例。结果46例中，肿瘤全切除（SimpsonⅠ、Ⅱ级）42例，次全切除（SimpsonⅢ级）4例。手术后视力改善39例，无改变5例，视力减退2例。结论适宜的手术入路和精细的显微外科技巧，可显著提高鞍结节脑膜瘤的手术疗效。

The Operative Approachs and Microsurgical Techniques of Tuberculum Sellae Meningiomas

Objective To explore the surgical approach selection and microsurgical techniques of microsurgical resection of tuberculum sellae meningiomas . Methods 46 cases of tuberculum sellae men-ingiomas were retrospectively analyzed . All the cases were performed by microsurgery . 19 cases via subfrontal approach ,14 cases via pterion approach ,7 cases via forehead-pterion combined approach ,and 6 cases via supraorbital keyhole approach . Results A total resection（Simpson gradeⅠandⅡ） was conduc-ted in 42 patients ,and a subtotal resection（Simpson grade Ⅲ） in 4 patients . Visual acuity was improved in 39 patients ,unchanged in 5 patients and worse in 2 patients . Conclusion Suitable approach selection and skilled microsurgical techniques can guarantee the surgical therapeutic effects .