显微手术治疗额-眶-蝶骨纤维异常增殖症

目的 探讨额-眶-蝶骨纤维异常增殖症的手术指征,评价一期进行病变骨切除+患侧视神经管减压+计算机塑形钛网颅骨缺损修补术的手术效果.方法 回顾性分析2007~2010年收治的15例额-眶-蝶骨纤维异常增殖症患者的临床资料,均通过一期进行病变骨切除+患侧视神经管减压+计算机塑形钛网颅骨缺损修补术治疗.结果 全部病例的病变骨质病理学检查结果均为骨纤维性结构不良.术后随访1~4年,15例患者20只视力受影响的眼中9只视力改善,11只视力稳定,无视力减退及明显副损伤;患者面容皆明显改观,效果满意.结论 累及额-眶-蝶骨的颅骨纤维异常增殖症伴视力下降的患者应尽早手术治疗,一期行病变骨切除+患侧视神经管减压+计算机塑形钛网颅骨缺损修补术,可有效防止视力下降、美观面容.

Microsurgery for fronto-orbito-sphenoidal fibrous dysplasia (report of 15 cases)

Objectives To investigate the surgical indications in the patients with fronto-orbito-sphenoidal fibrous dysplasia and to evaluate the curative effects of one-stage operation of removal of the sick skull bone, optic canal decompression and cranioplasty with digitized titanium mesh. Methods The clinical data of 15 patients with fronto-orbito-sphenoidal fibrous dysplasia who were treated by one-stage operation of the removal of the sick skull bone, optic canal decompression and cranioplasty with digitized titanium mesh from 2007 to 2010 were analyzed retrospectively, including clinical manifestations, the lesion site, characteristics of the imaging, operative method and key points, outcomes and so on. Results The fibrous dysplasia was confirmed pathologically in all the patients. Of 20 eyes in which the visual power decreased before the operation, 9 were improved in the visual power and 11 were unchanged after the operation. All the patients were improved in the face features. Conclusion The fronto-orbito-sphenoidal fibrous dysplasia patients with visual power reduction should be treated as soon as possible by one-stage operation of removal of the sick skull bone, optic canal decompression and cranioplasty with digitized titanium mesh.