神经内镜与显微手术切除前、中颅底肿瘤

The treatment of skull base tumors located in anterior-middle cranial fossa with neuroendoscope-assisted microneurosurgery

目的探讨神经内镜与显微神经外科技术在切除前、中颅底肿瘤中的意义和手术方法。方法应用神经内镜辅助的显微神经外科技术切除前、中颅底肿瘤89例,其中包括颅眶沟通瘤9例、颅鼻沟通瘤7例、颅眶鼻沟通瘤6例。在显微镜下尽可能切除可见的肿瘤部分,再用神经内镜寻找残余的肿瘤并切除。结果在常规显微神经外科切除肿瘤后,仍有不同程度的残余肿瘤,在内镜下进一步切除,80例(89.9%)肿瘤达全切除,6例(6.7%)获次全切除,3例(3.4%)为部分切除,无手术死亡。结论神经内镜辅助与显微神经外科技术切除前、中颅底肿瘤有助于提高肿瘤全切率,减少手术创伤。

Objective To investigate the clinical effects of neuroendoscope-assisted rnicroneurosurgery on the treatment of skull base tumors located in anterior-middle cranial fossa. Methods Eighty-nine patients with intraeranial tumors in anterior-middle cranial fossa were treated with neuroendoseope-assisted mieroneurosurgery. Of which, nine cases were cranial orbital tumors, seven eases were cranial nasal tumors, and six eases were nasal orbital tumors. After the resection of large part of tumor by routine mieroneurosurgery, the remainder of the tumors was discriminated and removed using neuroendoseope. Results Varied degrees of tumor remaining in our group were found after routine resection by mieroneurosurgery. By the assistance of neuroendoscope, further resection was achieved and eighty cases （ 89.9% ） were totally removed, six cases （ 6. 7% ） were subtotally removed, three eases （ 3.4% ） were partially removed. There was no operating-related death. Conclusion Neuroendoseope-assisted neuromierosurgery can effectively improve the total resection rate for skull base tumors located in anterior-middle cranial fossa, and reduce the operating-related injury.