颅眶沟通性肿瘤的显微外科治疗  

Microsurgery for cranio-orbital tumors(report of 27 cases)

作　　者：杨春春[1] 魏祥品[1] 牛朝诗[1] 傅先明[1] 钱若兵[1] 汪业汉[1] 范振[1] 

机构地区：[1]安徽医科大学附属省立医院神经外科,合肥230001

出　　处：《中国临床神经外科杂志》2011年第12期705-707,共3页Chinese Journal of Clinical Neurosurgery

摘　　要：目的探讨颅眶沟通性肿瘤显微手术治疗的效果及其相关技巧。方法 2000年5月至2011年5月对27例颅眶沟通性肿瘤患者进行了手术治疗。根据肿瘤的生长方式及对眼眶的累及情况选用不同的手术入路,其中经额颞眶顶入路手术17例,眶上-翼点入路5例,改良翼点入路5例。结果肿瘤全切除21例,次全切除4例,部分切除2例;肿瘤全切除率为77.8%(21/27)。术后病理学检查示脑膜瘤19例,转移癌2例,视神经胶质瘤1例,视神经纤维瘤4例,泪腺混合瘤1例。术后随访6年,2例死亡,22例仍存活,3例随访半年后失去联系。结论颅眶沟通性肿瘤首选的治疗方法为手术,选择合适的手术入路、娴熟的显微手术操作对于全切除肿瘤及减少术后并发症十分重要。Objective To explore the skills of microsurgery for the eranio-orbital tumors. Methods The clinical data of 27 patients with cranio-orbital tumors who underwent microsurgery from May, 2000 to May, 2011 were analyzed retrospectively. Of 27 patients with cranio-orbital tumors, 17 underwent microsurgery through the fronto-temporo-orbito-parietal approach, 5 through the supraorbital-pterional approach and 5 through the improved pterional approach. Results The tumors were totally removed in 21 patients （77.8%）, subtotally in 4, partially in 2. The postoperative pathological examination showed that, of 27 tumors, 19 were meningiomas, 2 metastatic carcinoma, 1 optic nerve glioma, 4 optic nerve fibromata and 1 mixed tumor of the lacrimal gland, The operative complications included the deterioration of vision in 2 patients and the disturbance of abducent function of the eyeball in 1. The follow-up for 6 years showed that 22 survived and 2 died. Three patients were out of contact with us 6 months after the surgery. Conclusions The cranio-orbital tumors should be resected by microsurgery. The appropriate mierosurgical approach and skillful microsurgical technique are very important to total resection of the tumors and decrease in the postoperative complications.

关 键 词：颅眶沟通性肿瘤 手术 技巧 疗效 

分 类 号：R739.45[医药卫生—肿瘤] R651.11[医药卫生—临床医学]