眶外侧锁孔入路治疗鞍结节脑膜瘤22例手术效果探讨

眶外侧锁孔入路治疗鞍结节脑膜瘤22例手术效果探讨

陈震,颜士卫,孙勇,黄正千,李宁,刘希光

江苏省连云港市第一人民医院徐州医科大学附属连云港医院神经外科,江苏省连云港市第一人民医院徐州医科大学附属连云港医院神经外科,江苏省连云港市第一人民医院徐州医科大学附属连云港医院神经外科,江苏省连云港市第一人民医院徐州医科大学附属连云港医院神经外科,江苏省连云港市第一人民医院徐州医科大学附属连云港医院神经外科,江苏省连云港市第一人民医院徐州医科大学附属连云港医院神经外科

收稿日期:2017-06-21 修回日期:2017-09-11 出版日期:2017-11-25
基金资助:
江苏省连云港市科学技术局社会发展项目（项目编号：SH1534；项目名称：眶外侧锁孔入路的神经和视交叉微血管解剖研究及其临床意义）

Surgical Treatment on 22 Cases of Tuberculum Sellae Meningiomas by Orbital Lateral Keyhole Approach

Zhen CHEN,Shiwei YAN,Yong SUN,Zhengqian HUANG,Ning LI and Xiguang LIU

Xuzhou Medical University,Lianyungang Hospital,Department of Neurosurgery,Lianyungang,Jiangsu Province,China,222002,Xuzhou Medical University,Lianyungang Hospital,Department of Neurosurgery,Lianyungang,Jiangsu Province,China,222002,Xuzhou Medical University,Lianyungang Hospital,Department of Neurosurgery,Lianyungang,Jiangsu Province,China,222002,Xuzhou Medical University,Lianyungang Hospital,Department of Neurosurgery,Lianyungang,Jiangsu Province,China,222002,Xuzhou Medical University,Lianyungang Hospital,Department of Neurosurgery,Lianyungang,Jiangsu Province,China,222002,Xuzhou Medical University,Lianyungang Hospital,Department of Neurosurgery,Lianyungang,Jiangsu Province,China,222002

Received:2017-06-21 Revised:2017-09-11 Online:2017-11-25

摘要/Abstract

摘要： 目的：鞍结节脑膜瘤是鞍上常见肿瘤，常累及视神经，首发症状多为视力损伤，切除肿瘤的同时提高或保留患者视力尤为重要。方法：对经眶外侧锁孔入路手术的22例鞍结节脑膜瘤患者的临床资料进行回顾性分析，采用Simpson分级来评估肿瘤的切除程度。结果：手术切除肿瘤达到Simpson Ⅰ级7例，SimpsonⅡ级切除14例，SimpsonⅢ级切除1例；视力好转18例，视力无减退2例，视力恶化2例，嗅觉丧失2例，减退4例，无手术死亡患者。结论：眶外侧锁孔入路治疗鞍结节脑膜瘤创伤小，对视神经和嗅觉功能保护更好。

Abstract: Objective： Tuberculum sellae meningiomas(TSMs) were suprasellar lesions that commonly extended to the optic nerve， resulting in visual impairments as the initial and most common symptoms. The primary goal of surgical treatment for TSM is the preservation or improvement of visual function. Outcomes were complete tumor removal， improvements of visual impairments and survival to the surgery.Methods：A retrospective analysis was performed on 22 patients with TSMs associated with visual impairments. These patients underwent microsurgery using the keyhole lateral supraorbital craniotomy. Results：After surgery， patients were classified according to Simpson classification： Grade Ⅰ in 7 cases， grade Ⅱ in 14 cases， and grade Ⅲ in 1 cases. Postoperatively， visual impairments were improved in 18 cases， unchanged in 2 cases， and worsened in 2 cases. Postoperative deterioration occurred in 4 cases and an anosmia in 2 cases. There was no patient′s death. Conclusion：TSMs can be exposed and treated very well by microsurgery through lateral supraorbital keyhole approach， which has the advantages such as less rsik of olfaction and visual damage.

陈震,颜士卫,孙勇,黄正千,李宁,刘希光. 眶外侧锁孔入路治疗鞍结节脑膜瘤22例手术效果探讨[J]. .

Zhen CHEN,Shiwei YAN,Yong SUN,Zhengqian HUANG,Ning LI and Xiguang LIU. Surgical Treatment on 22 Cases of Tuberculum Sellae Meningiomas by Orbital Lateral Keyhole Approach[J]. .

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