神经内镜经眶上外侧入路联合腰大池置管切除嗅沟脑膜瘤8例报告  

Neuroendoscopic Lateral Supraorbital Approach with Lumbar Cistern Drainage for Olfactory Groove Meningioma Resection:a Report of 8 Cases

作　　者：王海滨 袁上桂 廖林生 高志强[1] 杨少春[1] WANG Hai-bin;YUAN Shang-gui;LIAO Lin-sheng;GAO Zhi-qiang;YANG Shao-chun(Department of Neurosurgery,Institute of Neurology,the First Affiliated Hospital of Gannan Medical University,Ganzhou 341000,China;Department of Neurosurgery,Xingguo County Second Hospital,Xingguo 342400,China;Department of Neurosurgery,Dayu County People’s Hospital,Dayu 341500,China)

机构地区：[1]赣南医学院第一附属医院神经外科、赣南医学院第一附属医院神经病学研究所,江西兴国341000 [2]兴国县第二医院神经外科,江西兴国342400 [3]大余县人民医院神经外科,江西大余341500

出　　处：《南昌大学学报（医学版）》2023年第2期66-69,共4页Journal of Nanchang University：Medical Sciences

基　　金：赣州市科技局指导性科技计划项目(GZ2020ZSF086)。

摘　　要：目的探讨全程神经内镜经眶上外侧入路切除嗅沟脑膜瘤的手术疗效。方法回顾性分析采用神经内镜经眶上外侧入路联合腰大池置管引流切除8例嗅沟脑膜瘤患者的临床资料。其中男3例,女5例,头痛5例,嗅觉减退2例。结果8例患者中,按Simpson切除标准,肿瘤Ⅰ级切除6例(肿瘤最大径2.4~<4 cm),Ⅱ级切除2例(肿瘤最大径4~6 cm),术后病理检查证实为脑膜瘤(WHOⅠ级)。术后未出现死亡及颅内感染病例,5例头痛患者疼痛缓解,2例嗅觉减退患者未出现嗅神经损伤,症状基本同术前,1例癫痫患者术后随访1年未见发作。Ⅱ级切除2例患者未出现术后并发症,但影像学显示部分额叶损伤。术后随访6个月至2年,影像学检查均未见复发。结论神经内镜经眶上外侧入路手术具有创伤小、术野广且清晰等优点,可全程内镜下切除,且更适用于直径小于4 cm的嗅沟脑膜瘤患者。Objective To investigate the efficacy of neuroendoscopic lateral supraorbital approach for olfactory groove meningioma resection.Methods The clinical data of 8 patients(3 males and 5 females)who underwent neuroendoscopic lateral supraorbital approach and lumbar cistern drainage for olfactory groove meningioma resection were retrospectively analyzed,including 5 cases of headache and 2 cases of anosmia.Results Among the 8 patients,6 underwent Simpson gradeⅠresection(the maximum tumor diameter 2.4-<4 cm),and 2 underwent Simpson gradeⅡresection(the maximum tumor diameter 4-6 cm).The meningiomas were confirmed by postoperative pathology(WHO grade I).No death or intracranial infection occurred after operation.The pain was relieved in the 5 headache patients.No olfactory nerve injury was found,and the postoperative symptoms were basically the same as those before surgery in the 2 hyposmia patients.No epileptic attack was observed in a seizure patient after 1 year of follow-up.Although no postoperative complications occurred,imaging examination showed partial frontal lobe injury in the 2 patients who underwent gradeⅡresection.After 6 months to 2 years of follow-up,imaging examination displayed no recurrence.Conclusion Neuroendoscopic lateral supraorbital approach has the advantages of minimal invasion,wide and clear vision,and endoscopic resection.It is also more suitable for patients with olfactory groove meningiomas less than 4 cm in diameter.

关 键 词：嗅沟脑膜瘤 神经内镜 眶上外侧入路 腰大池置管 肿瘤直径 

分 类 号：R739.45[医药卫生—肿瘤]