侵及眶部脑肿瘤的临床特征与显微手术处理

The clinical characteristics and microsurgical management of brain tumors invading orbital region

目的研究侵及眶部的脑肿瘤临床特征与显微外科手术治疗效果。方法对58例本病经临床分析与影像学检查而获诊断,采用不同手术入路及显微外科技术切除肿瘤。全组病例中,肿瘤位于前颅凹50例,中颅窝8例,均侵及眶腔。其中39例(67.2%)有头痛、头晕等颅内压增高表现,54例(93.1%)出现视器症状。结果本组46例肿瘤(79.3%)获手术全切除,12例(20.7%)为次全切除,无死亡。对48例经信访或门诊随访6个月-9年(平均3.6年),39例(81.3%)恢复满意,余9例(18.7%)有不同程度后遗症。结论脑肿瘤侵及眶部多以视器改变为主要临床表现。采取不同手术入路、以显微外科技术切除本类肿瘤,预后良好。

Objective To study the effectiveness of the clinical characteristics and management of brain tumors invading orbital region. Methods The tumors were diagnosed via the clinical analysis and imaging test in fifty-eight patients. The tumors were excised with different approaches and the microsurgical technique. In this series, all tumors invaded into the orbital cavity from the anterior （50 cases） or middle fossa （8 cases） , including the supraorbital ridge, orbital roof and lateral wall and floor. The patients showed the headache, swirl as symptoms of increased intracranial pressure in 39 cases （67.2%） , and had malfunction of optic organs in 54 （93.1%） . Results The tumors had a total removal in 46 cases （79.3%） and subtotal removal in 12 （20.7%） . No patients died in our group. Patients follow-up ranged from 6 months to 9 years with a mean of 3.6 years in 48 cases, showed that 39 cases （81.3%） recovered to normal life and 9 cases （18.7%） had different degree of sequela. Conclusions One of the mostcommon clinical manifestation of brain tumors invadingorbital region is disorders in optic organs. The microsurgical technique, as well as combined operative approaches may result in a good prognosis for these patients.