复杂性颅-眶肿瘤的诊断与手术处理

The Diagnosis and Microsurgical Treatment of the Complex Cranio-orbital Tumors

目的 探讨复杂性颅-眶肿瘤的诊断与显微外科治疗效果。方法 对61例进行颅眶肿瘤病例临床与影像学诊断，采用经眶开颅及经颅切开眶顶的手术入路、以显微外科技术切除肿瘤。结果 本组49例肿瘤（80．3％）获手术全切除，12例（19．7％）为次全切除，无死亡。对50例进行随访调查，随访期6～108月（平均43．2月），其中41例（82．0％）恢复满意，余9例（18．0％）有不同程度后遗症。结论 复杂性颅-眶肿瘤多以视器改变为主要临床表现。根据肿瘤起源的部位与大小，选择适宜的手术入路和显微外科技术切除本类肿瘤，效果良好。

Objective To probe the diagnosis and effectiveness of the microsurgical treatment for complex cranio-orbital tumors. Methods These tumors were diagnosed via the clinical analysis and imaging test in sixty-one patients. In this series, all tumors involve into the orbital cavity, including the supraorbital ridge, orbital roof and lateral wall and floor in intracranial. The patients showed the malfunction of optic organs in 57（93.4%）. The tumors were excised utilized the transcranlal approach to the orbit and transcranial approach with resection of orbital roof, and the microsurgical technique. Results The tumors had a total removal in 49 cases （80. 3%） and subtotal removal in 12 （19. 7%）. At postoperation, patients had a resume all right and no death in our group, Patients follow-up ranged from 6 months to 9 years with a mean of 3. 6 years in 50 cases, showed that 41 cases （82. 0%）resume normal life and 9 cases （18. 0%） with different degree sequela, Conclusion One of the most corrmaon clinical manifestations of the complex cranio-orbital tumors is disorders in optic organs. The choice of the most suitable operative approach for this lesions is made on the basis of tumor location, size, apparent site of origin, as well as combined microsurgical technique, may result in a good results for these patients,