颅咽管瘤经蝶显微手术治疗

目的:经蝶显微手术切除颅咽管瘤,适用起源于鞍底的肿物或向鞍上扩展者。作者回顾性总结了18例颅咽管瘤的诊断方式、手术技巧和治疗结果。方法:本组均经计算机体层摄影(CT)或磁共振成像(MRI)扫描确诊。手术采取经唇下—鼻中隔—蝶窦入路或经鼻前庭-鼻中隔—蝶窦入路两种方式行肿瘤切除术。结果:9例肿瘤获全切除,4例次全切除,其余5例为部分切除,无术后死亡。15例获长期随访(平均随访期为3年1个月),有12例(80％)恢复良好,3例影像学检查提示肿瘤复发,需行再次手术、放疗或放射外科治疗。结论:对颅咽管瘤选择合适病例经蝶入路显微手术切除,是一种安全、有效的方法。

Transsphenoidal microsurgical treatment of craniopharyngiomas

Transsphenoidal microsurgical removal is indicated for craniopharvngiomas originated from sella turcica and/or with suprasellar extension. This paper reviewed the diagnostic modes, surgical technique, and therapeutic outcome of 18 patients with craniopharyngioma. Method :Preoperative diagnosis was made by CT or MRI scan. Operations were performed via either sublabio-septo-sphenoidal approach or nasovestibulo-sphenoidal approach. Result: Total removal of the tumor were achieved in 9 cases, subtotal in 4 cases and partial in 5 cases. There was no postoperative mortality. Long-term follow-up study (average 3. 1 years) of 15 patients revealed good recovery in 12 patients (80%), and late recurrence in 3 cases (20 % ). The patients with recurrence needed reoperation, radiotherapy, and radiosurgery used either alone or combined. Conclusion: It is a safe and effective method by using the microsurgical technique via transsphenoidal approach to remove craniopharyngioma for selected patients.