额下经蝶入路显微手术切除鞍区肿瘤20例报告

目的　报告２０ 例鞍区肿瘤采用额下经蝶入路显微手术的体会， 确立一种手术方法，评价其利弊。方法　额部骨瓣开颅后， 先切除肿瘤的鞍上部分， 而后磨除鞍结节、蝶骨平台及蝶鞍前壁骨质， 显露并切除鞍内及蝶窦内肿瘤。结果　全切１８ 例， 近全切除２ 例。脑脊液鼻漏３ 例， 无颅内感染及死亡。结论　该入路适于一期手术全切除鞍内及鞍上的肿瘤， 尤其适于肿瘤侵入蝶窦内并且合并视交叉前置的患者， 值得重视和推广。

Microsurgical treatment of sellar tumor by subfrontal transsphenoidal approach

Objective To report microsurgical experience with 20 cases of sellar tumors resected by subfrontal transsphenoidal approach, establish a surgical method and evaluate its benefit and harm. Methods After performing a frontal craniotomy, suprasellar part of the lesion was resected via subfrontal approach, and then the bone planum of sphenoidale, tuberculum sellae and anterior sellar wall were removed by microdrill. After that, the tumor within the intrasellar and/or in the sphenoid sinus was exposed and excised.Results Total resection was achieved in 18 cases, subtotal in 2 cases. After operation there were 3 cases with CSF leak, but no intracranial infection occurred and no patient died in this group. Conclusion This approach is very appropriate remove the tumor located intrasellar and suprasellar at one stage, especially to the tumor invaded sphenoid sinus and accompanied with prefixed optic chiasm. It is worth to be paid more attention and employ widely.