蝶窦内间隔与经单鼻孔-蝶窦-鞍区肿瘤切除术效果分析  

Relationship of sphenoid intersinus septa with transsphenoidal resection of sellar ~rea tumor

作　　者：魏群[1] 李运军[1] 沈春森[1] 何江弘[1] 秦家振[1] 罗永春[1] 梁春阳[1] 徐如祥[1] 

机构地区：[1]北京军区总医院附属八一脑科医院,北京军区总医院神经外科研究所,北京100700

出　　处：《中华神经医学杂志》2011年第7期697-699,共3页Chinese Journal of Neuromedicine

摘　　要：目的对蝶窦内间隔特点及经蝶窦-鞍区肿瘤手术的关系进行探讨。方法分析北京军区总医院附属八一脑科医院自2008年1月至2010年12月收治的107例经单鼻孔-蝶窦-鞍区肿瘤切除术患者的术前蝶窦内间隔资料，并用以指导术中操作。结果本组肿瘤全部切除67例（62．6％），大部切除21例（19．6％），部分切除19例（17．8％）。其中47例根据蝶窦间隔的指示，迅速确定肿瘤所在鞍底位置，或保留无关间隔，并根据间隔确认颈内动脉位置，避免损伤；11例存在复杂蝶窦内间隔者，根据影像学提示得以快速判定鞍底与间隔的关系并确定蝶窦内骨质切除范围与方向，顺利完成手术。手术相关并发症：左侧颈内动脉破裂1例，海绵窦破损4例。结论术前仔细判读蝶窦内间隔影像学资料，用以指导经蝶寞-鞍区肿瘤手术操作，可以预防和减少并发痒。Objective To study transsphenoidal resection of sellar area tumor. the relationship of sphenoidal intersinus septa with Methods The pre-operative MRI and CT images of the sphenoid intersinus septa and its importance in transsphenoidal resection ofsellar area tumor were studied in 107 patients, admitted to our hospital fi＇om January 2008 to December 2010. The amounts, locations, anatomic specialties of the septa and its relationships with the floor of selle, the internal crotid artery canals and the tumors were analyzed to guide the operative procedures during the operation. Results Total removal of the tumors in seller region was obtained in 67 patients, subtotal removal in 21 and partial removal in 19. According to the MRI and CT images of the sphenoid intersinus septa, the location of the tumor and the carotid artery in 47 patients were quickly determined; complex sphenoid intersinus septa was noted in 11 patients, and the relation of sellar floor with the septa was quickly determined and the scope and direction of removal were determined too. Rupture of the internal carotid artery occurred in 1 patient, and damages of the cavernous sinuses occurred in 4. Conclusion Careful study of the pre-operative MRI or CT images of the sphenoidal intersinus septa and its relationship with the floor of seller, the internal carotid artery and the tumor will assure the transspenoidal surgery more precisely and safely, and the complication can be efficiently prevented and decreased.

关 键 词：蝶窦 间隔 手术治疗 

分 类 号：R736.4[医药卫生—肿瘤]