单纯神经内窥镜手术治疗三脑室内囊性颅咽管瘤效果

Endoscopic neurosurgery for cystic craniopharyngiomas in third ventricle

目的探讨单纯神经内窥镜手术在三脑室内囊性颅咽管瘤治疗中的作用。方法对三脑室内囊性颅咽管瘤伴有梗阻性脑积水的11例患者,应用神经内窥镜缩小肿瘤体积、解除梗阻性脑积水、穿通囊内分隔并行囊腔与第三脑室和/或侧脑室的内造瘘术,术后辅以放射治疗。结果11例患者术后颅内压增高症状均消失、术前症状改善。影像学复查(CT及MR I)见肿瘤均缩小、脑积水明显减轻或消失。除1例少儿术后昏睡2 d外,余无其他严重并发症。结论对三脑室内囊性颅咽管瘤并伴有脑积水者,采用单纯神经内窥镜手术,术后辅以放射治疗是进一步提高治疗效果、减少严重并发症的有效方法。

Objective To investigate the role of neuroendoscope in treatment of cystic craniopharyngiomas in the third ventricle. Methods Neuroendoscope was applied to minimize the volume of the tumors, relieve obstructive hydrocephalus, canalize the intervals of the cysts, and fistulate into the third ventricle or the lateral ventricle and the cysts in 11 patients of cystic craniopharyngiomas in third ventricle accompanied with obstructive hydrocephalus, then radiotherapy followed. Results The symptoms of the intracranial hypertension disappeared and the other symptoms improved postoperatively in all 11 patients. CT imaging and MRI showed that the tumors shrunk and hydrocephalus faded. No severe complications occurred in all patients except l patient affected with transitory lethargy. Conclusion Neuroendoscopic technique is effective in improving curative effect and decreasing severe complications in the patients with cystic craniopharyngiomas in the third ventricle accompanied with hydrocephalus.