眶上微骨窗入路显微手术切除鞍上脑膜瘤  

Supraorbital minicraniotomy approach for microsurgical treatment of suprasellar meningiomas

作　　者：张圣邦[1] 冯春国[1] 万经海 程宏伟[1] 徐培坤[1] 李长元[1] 李学记 

机构地区：[1]安徽医科大学第一附属医院神经外科,合肥230022 [2]中国医学科学院协和医科大学肿瘤医院神经外科

出　　处：《中华显微外科杂志》2009年第2期104-106,共3页Chinese Journal of Microsurgery

摘　　要：目的介绍经眶上微骨窗入路切除鞍上脑膜瘤的显微外科技术和经验。方法经眉内小切口5例，经翼点入路16例，采用眶上约3．5cm×2．5cm小骨窗开颅，显微外科技术切除鞍上脑膜瘤21例，肿瘤最大径2．8—6．2cm，回顾分析其临床资料。结果所有肿瘤显露良好，SimpsonⅠ级切除5例，SimpsonⅡ级切除15例，Simpson Ⅲ级切除1例。无手术死亡及严重并发症，术前视力障碍患者术后均有不同程度改善。术后随访6个月至5年，平均3．8年，影像学上肿瘤残留1例。结论眶上微骨窗入路可替代传统额下或翼点入路切除鞍上脑膜瘤并具有手术创伤小、术后恢复快等优点。Objective To investigate the microsurgieal technique,indications, advantages and limitations of the supraorbital minicraniotomy approach via an eyebrow skin incision or a fronto-temporal skin incision for resection of the suprasellar meningiomas. Methods Retrospective analysis of consecutive 21 cases with suprasellar meningiomas who were treated microsurgically in our hospital. All tumors were resected via a small eyebrow incision or a fronto-temporal skin incision through a supraorbital minicraniotomy. Results This approach can provided excellent exposure to all the tumors .The Simpson grade Ⅰ , Ⅱ,Ⅲ dissection of tumor was achieved in 5, 15 and 1 cases respectively. There were no severe complications and operative death. The cases with visual deficits had all improved in some degree. The average follow-up period was 3.8 years ranged from 6 months to 5 years, tumor was residual in one case. Conclusion It seems that the supraorbital minicraniotomy approach is simple, less invasive and useful as an alternative to traditional subfrontal or pterional approach for resecting suprasellar meningiomas. It provides excellent exposure to suprasellar meningiomas.

关 键 词：眶上骨窗 鞍上脑膜瘤 微创外科手术 

分 类 号：R739.4[医药卫生—肿瘤]