改良经颅开眶入路切除眶尖肿瘤23例疗效分析  

Curative Effect Analysis of 23 Cases Patients with Modified Osteotomy of Transcranial Orbital approach for Orbital Apex Tumor

作　　者：林育华[1] 杨帆[1] 谢怀林[1] 蒋广元[2] 梁新强[2] 

机构地区：[1]广西壮族自治区南溪山医院眼科,541002 [2]广西壮族自治区南溪山医院神经外科,541002

出　　处：《中国医药指南》2010年第12期25-26,共2页Guide of China Medicine

摘　　要：目的探讨改良经颅开眶入路摘除眶尖肿瘤的疗效。方法回顾性分析23例眶尖、视神经管或颅眶沟通肿瘤手术,先经神经外科作经额部的四边形额肌骨瓣,然后沿前颅窝底整块取下眶顶骨板或分两块眶顶骨板,切开骨膜进入眶内,由眼科医师完成眶内肿瘤切除,再由神经外科医师继续处理有颅眶沟通者的颅内部分并关闭切口。结果23例中有20例完整摘除肿瘤,3例部分摘除。术后视力无下降,术前19例视力下降者,术后14例有提高。眼球突出度平均降低2.0mm;眼球轻度下陷1例;术后发热1例。无1例发生与开颅有关的并发症。结论眼科与神经外科联合行改良经颅开眶入路眶尖肿瘤摘除术,能够最大限度的暴露眶尖肿瘤,达到完整摘除肿瘤的目的,有利于减少手术并发症的发生,疗效满意。Objective To explore the effect and safety of the modified osteotomy of transcranial orbital approach for orbital apex tumor. Methods We retrospective 23 surgical cases of orbital apex, canales opticus, or cranio-orbital tumors. Surgery first be made by the neurosurgery department. The neurosurgeon made transfrontal 4-polygon frontalis muscle flap, and then along the basefond of anterior cranial fossa, removed bone plate on the orbital roof, cut into the orbital periosteum. Followed by an ophthalmologist for removal of orbital tumor operation, then a neurosurgeon continue to deal with cranio- orbital, intracranial part of the communicator and close the incision. Results 20 patients were completely removed tumor, 3 patients with partial removal. No decline in visual acuity, preoperative visual acuity decrease, in 9 cases, 4 cases after operation have been improved. Exophthalmos average drop of 2.0ram; eyeball one cases of mild subsidence; postoperative fever in case. No one cases with craniotomy-related complications occurred. Conclusions Department of ophthalmology and neurosurgery, joint via fronto-orbital approach orbital apex tumor enucleation, the problem of difficulty in orbital apex tumors expose can be satisfactorily resolved. Most benign tumors can be removed or even a complete removed under a microscope. This will help to reduce the incidence of surgical complications, and the results were satisfactory.

关 键 词：眼眶肿瘤 经颅开眶手术 

分 类 号：R739.72[医药卫生—肿瘤]