额外侧前颅底锁孔入路处理额部及鞍区病变

目的探索额外侧前颅底锁孔入路在处理额部及鞍区病变中的应用价值。方法沿鬓发迹前缘向额侧不超过5cm弧形切口,做小于3cm骨窗,利用额外侧及额下间隙处理额部、鞍区病变33例。结果 9例垂体腺瘤、7例鞍结节脑膜瘤、6例颅咽管瘤、4例额叶胶质瘤、2例脑膜瘤、1例额叶海绵状血管畸形经此手术入路均显露充分,视野清晰,切除彻底。4例后交通动脉瘤解剖清晰,夹闭满意。结论额外侧前颅底锁孔入路具有微创,影响容貌小、操作简单,能够显露和处理额叶侧方、前颅窝底及鞍区病变的优点。

Microsurgery through frontolateral and anterior skull base keyhole approach for lesions in the frontal and sellar region

Objective To explore the value of microsurgerty through frontolateral and anterior skull base keyhole approach to treatment of lesions in the frontal and sellar region. Methods The microsurgery through frontolateral anterior skull base keyhole approach was performed in 33 patients with frontal and sellar region lesions of whom, 9 suffered from pituitary adenomas, 7 meningiomas in tuberculum sellae, 6 craniopharyngiomas, 4 posterior communicating arteries aneurysms, 4 gliomas in the frontal lobes, 2 meningiomas in the frontal lobes and 1 cavernous angioma in the frontal lobe. Results The tumors were totally resected in the 29 patients with frontal and sellar region tumors and aneurysms were satisfactory clipped in 4 patients with posterior communicating arteries aneurysms. No complications related to the operative approach occurred in all the patients. Conclusion The lesion in the frontolateral anterior skull base and sellar region can be exposed and treated very well by microsurgery through frontolateral and anterior skull base keyhole approach, which has the advantages such as minimal invasion, less effect on the patient’s look and simple procedure.