颅眶沟通肿瘤的临床特征与手术治疗  

Clinical feature and microsurgical treatment of cranio-orbital tumor

作　　者：李宏[1] 李景荣[1] 宋国祥[1] 

机构地区：[1]天津医科大学第二医院神经外科,300211

出　　处：《中国肿瘤临床与康复》2008年第1期63-66,共4页Chinese Journal of Clinical Oncology and Rehabilitation

摘　　要：目的研究同时侵犯颅内和眶部肿瘤的临床及病理特征与神经外科显微手术治疗方法。方法对102例经临床分析与影像学检查而获诊断的病例采取不同的手术入路,并根据术中冰冻活检的结果采取显微外科技术切除肿瘤,术中对需要保留视力的患者行闪光视觉诱发电位(F-VEP)监测。全组病例中,肿瘤位于前颅凹-眼眶67例,中颅凹-眼眶26例,前颅凹-中颅凹-眼眶9例。其中91例(89.2%)出现突眼、视力下降、眼肌麻痹等视器症状。62例(60.8%)有头痛、头晕等颅内压增高表现。结果本组81例(79.4%)肿瘤获手术全切除,21例(20.6%)为次全切除,无死亡病例。对93例经信访或门诊随访6个月至14年(平均5.6年),70例(75.3%)恢复满意,7例(7.5%)复发,余16例(17.2%)有不同程度后遗症。结论颅眶沟通肿瘤同时侵犯颅内及眼眶,多以视器改变为主要临床表现。采取不同的手术入路并根据术中冰冻活检的结果指导显微外科技术切除该类肿瘤,预后良好,术中采取F-VEP监测,可以减少手术对视神经的损伤。Objective To study the clinical feature and microsurgical treatment of tumors involving the cranio-orbital region. Methods In 102 cases who had been diagnosed by clinical manifestations and neuroradiological features, different approaches of operation were used, and according to the results of frozen biopsy in operation, microsurgical techniques were used to resect the tumors. Sixty-seven cases had their tumor located in anterior cranial fossa-orbit,26 in middle cranial fossa-orbit and 9 in anterior and middle cranial fossa-orbit. Ninty-one cases（89.2% ） showed malfunction of optic organs. Sixty-two cases（60.8% ） had symptoms of intracranial hypertension. Results Eighty-one cases received total removal and others subtotal resection of tumors. No postoperative death occured. Ninety-three patients were followed up for 6 months to 14 years with a mean of 5.6 years. Of them,70（75.3% ） recovered satisfactorily,7 （7.5%） suffered recurrence and 16 （ 17.2% ） had different degrees of sequela. Conclusions One of the most common manifestations of cranio-orbital tumor is disorders of optic organs. The microsurgical technique,with different operative approaches and directed by frozen biopsy in operation can result in good prognosis for these patients. The injury to optic nerve could be reduced by using F-VEP monitor in operation.

关 键 词：颅眶沟通肿瘤 冰冻活检 F-VEP 显微神经外科手术 

分 类 号：R739.4[医药卫生—肿瘤]