经眶颧入路显微手术切除海绵窦肿瘤  

Transorbitozygomatic microsurgery for cavernous sinus tumors

作　　者：刘宁[1] 朱风仪[1] 

机构地区：[1]南京医科大学第一附属医院神经外科,南京市210029

出　　处：《中华显微外科杂志》2005年第4期317-319,共3页Chinese Journal of Microsurgery

基　　金：江苏省科技厅社会发展重点资助项目(BS2000050)

摘　　要：目的探讨经眶颧入路显微切除海绵窦肿瘤的手术方法与临床疗效。方法回顾性研究经眶颧入路显微切除的19例海绵窦肿瘤,对肿瘤病理类型、临床和影像学特征、手术入路、手术切除技巧及术后并发症等进行系统分析。结果在手术显微镜下肿瘤全切除17例,近全切除2例。术后原有脑神经症状38%得到改善,43%同术前,19%加重,出现重的脑神经症状5例。无其它严重并发症及死亡病例。结论经眶颧入路可以较好地显露并全切除海绵窦肿瘤,熟知该入路的巨-微解剖、肿瘤与海绵窦结构的病理解剖关系以及熟练的显微手术技能是全切除肿瘤并有效地保护脑神经的关键。Objective To explore the microsurgical skills and clinical value of transorbitozygomatic approach for cavernous sinus tumors. Methods A retrospective research was given to 19 patients with cavernous sinus tumors microsurgically treated by transorbitozygomatic approach. Their tumors pathological types, clinic symptoms, characteristic images, surgical approach, surgical skills and postoperative complications were systemically analyzed. Results Total removal of the tumor was achieved in 17 cases and subtotal removal in 2 cases. 38 percent of cranial nerves deficit was improved, 43 percent of cranial nerves symptoms did not change, and 19 percent of cranial nerves palsies worsened. New cranial nerves symptoms occurred in 5 cases. No other severe complications or death occurred in all cases. Conclusion Transorbitozygomatic approach can preferably expose and totally resect cavernous sinus tumors. Knowing macro-micro anatomy of this approach, understanding the pathological-anatomic relationships betweem tumor and cavernous sinus, having practiced microsurgical skills are the linchpins to rcsect the tumor totally and protect cranial nerves effectivctively.

关 键 词：海绵窦 脑肿瘤 颅底 显微外科手术 显微手术切除 海绵窦肿瘤 眶颧入路 肿瘤全切除 术后并发症 临床疗效 

分 类 号：R739.4[医药卫生—肿瘤]