鞍结节脑膜瘤手术入路探讨

Research for the surgical approach of tuberculum sellae meningiomas.

比较单侧额底入路与双额纵裂入路切除鞍结节脑膜瘤的疗效差异。方法将６７例鞍结节脑膜瘤随机分为２组，分别采用单侧额底入路和双额纵裂入路进行手术切除。结果二组的肿瘤全切除率、视力改善率、术后死亡率等均相似，但单侧额底入路组的双侧嗅神经损伤率、双侧额叶损伤率均较双额纵裂入路组显著减少。结论采用单侧额底入路可对各种大小的鞍结节脑膜瘤进行手术切除，并可减少手术创伤。

Objective To compare the effects in the treatment of meningioma of tuberculum sellae with unilateral subfrontal approach and bifrontal trans-longitudinal fissure approach. Methods Sixty-seven cases of meningiomas of tuberculum sellae were randomly divided into two groups,unilateral subfrontal approach and bifrontal trans-longitudinal fissure approach, to dissect the tumors. Results The rate of total dissection, the visual improvement and the operative mortality were similar and the rate of olfactory nerve and frontal lobes injury in unilateral subfrontal approach group were significantly lower than that in bifrontal trans-longitudinal fissure approach. Conclusions Unilateral subfrontal approach can be adopted in the operation of miningioma of tuberculum sellae with wide size range and can decrease the incidence of operative injury.