前颅底及颅鼻眶沟通脑膜瘤的显微手术治疗

Microsurgical Treatment of Anterior Cranial Base and Cranial Nasal Orbital Communication Meningiomas

【目的】探讨前颅底及颅鼻眶沟通脑膜瘤显微手术切除与颅底重建的适应证及手术入路选择。【方法】总结本院收治的110例前颅底及颅鼻眶沟通脑膜瘤,经头颅CT或MRI扫描确诊,据肿瘤大小、部位选择不同的入路,显微镜下切除肿瘤并行颅底修复重建。【结果】镜下全切除肿瘤88例,次全切除17例,大部分切除5例;临床痊愈85例,好转23例,死亡2例。随访79例,肿瘤复发5例,行第2次手术切除。【结论】对于此类患者根据肿瘤的大小、部位选择不同的手术入路,显微镜下切除肿瘤,必要时颅底修复重建是一种安全、有效的方法。

[Objective]To research surgical treatment of anterior cranial base and cranial nasal orbital communication meningiomas, the indication of cranial base reconstruction and the choice of surgical approach. [Methods]One hundred and ten cases of meningioma were dignosised by CT and/or MRI. According to the size and site ,we chose the different approaches and removed tumors under microseope. Part of cases received cranial base reconstruction. [Results]The tumors were totally removed in 88 cases, subtotally in 17 cases and partially in 5 cases under microscope. Eighty five cases were cured, 23 cases improved, 2 cases dead. Seventy nine cases were followed up, 5 cases were recurrent. [Conclusion]According to the size and site ,meningiomas of anterior cranial base can be treated via different approaches under microscope and cranial base should be reconstructed if necessary.