蝶骨嵴内侧脑膜瘤的诊断治疗

Surgical treatment for medial sphenoid ridge meningioma

目的 探讨内侧型蝶骨嵴脑膜瘤手术治疗。方法 回顾性分析2001年12月至2003年4月手术治疗的38例内侧型蝶骨嵴脑膜瘤。结果 38例病例中,30例获得全切,6例获得次全切除,2例大部切除。术后死亡1人。随访30例,其中偏瘫2例,动眼神经麻痹3例;术前视力下降的16例病例中,术后视力改善11例,无变化3例,加重2例。结论 手术是治疗内侧型蝶骨嵴脑膜瘤的重要手段,显微操作和合理利用蛛网膜界面保护重要血管、神经可提高手术切除率,减少术后神经功能障碍。

Objective To discuss the surgical treatment of medial sphenoid ridge meningioma. Methods 38 cases of medial sphenoid meningiomas, admitted into our department from December 2001 to March 2003 and undergoing operations, were retrospectively analyzed. Results The medial sphenoid meningiomas were totally removed in 30 patients, subtotally in 6 cases and partially in 2 cases. Of all, postoperative death occurred in only one case and postoperative follow-up was performed on just 30 patients, among which hemiplegia happened in 2 and oculomotor nerve palsy in 3 patients. Among the 16 patients accompanied with eyesight loss preoperatively, 11 had vision improvement after operation, 3 remained unchanged and 2 deteriorated. Conclusion Surgical operation, as an important method in treatment of medial sphenoid ridge meningioma can be satisfactory in the increase of removal rate and the reduction of postoperative nervous malfunction only if added with micromanipulation and proper preservation of vital vessel and nerves by means of reasonable use of arachnoid interphase in operation.