神经导航辅助颅底肿瘤显微外科切除

Microsurgery resection of the skull base tumor under assisted neuronavigation

目的 探讨神经影像导航辅助下显微外科切除颅底肿瘤的效果。方法 回顾性研究我院 2 0 0 0年 1月至 2 0 0 3年 8月收治的 44例颅底肿瘤 ,其中垂体瘤 8例 ,鞍结节脑膜瘤 12例 ,颅咽管瘤 9例 ,桥小脑角肿瘤 7例 ,蝶骨嵴脑膜瘤 5例 ,后颅窝海绵状血管瘤 3例 ,应用StealthStation影像导航系统 ,导航辅助显微外科切除肿瘤。结果 导航头皮注册平均误差为 ( 2 .7± 1.2 )mm ,颅骨钻孔标记注册误差 ( 1.5± 0 .8)mm。 44例病人达到肿瘤全切 3 8例 ,全切率 86.4% ,肿瘤次全切 4例 ,大部切除 2例。手术并发症包括动眼神经损伤 2例 ,面神经麻痹 2例 ,一过性尿崩 6例 ,无手术死亡。结论 神经影像导航辅助下的颅底肿瘤显微外科切除 ,定位准确 ,能提高肿瘤全切除率 ,减少并发症。

Objective To study the effect of microsurgery resection of the skull base tumor under assisted neuronavigation.Methods Forty-four patients with skull base tumors,including 8 cases of pituitary tumor,12 cases of tuberculin sellae meningioma,9 cases of craniopharyngioma,7 cases of cerebellum-bridge-angle (CPA) tumors,5 cases of sphenoid ridge meningioma and 3 cases of angiocavernoma in post cranial fosse,from Jan. 2000 to Aug.2003 in our hospital were retrospectively studied. The Stealth Station image navigation system was adopted in microsurgery for the skull base tumors.Results The average error in skin inscription was 2.7±1.2 mm,and in cranial was 1.5±0.8 mm.The tumors were all respected in 38 patients,second respected in 4 patients and part respected in 2 patients.The complications included the injury of coulometer nerve occurrence in 2 patients,facial paralysis in 2 cases,temporary polypro in 6 patients.No operative death occurred.Conclusion Microsurgery resection of the skull base tumor under assisted neuronavigation was effective and trustworthy,could raise the respective rate of the tumor and decrease the occurrence of complications.