嗅沟脑膜瘤术式选择及长期临床预后随访

The election of microsurgical treatment of olfactory groove meningioma and long-term clinic follow-up

目的分析嗅沟脑膜瘤的手术治疗和随访结果。方法收集20例嗅沟脑膜瘤手术病例，并分析其临床表现及随访结果。结果嗅沟脑膜瘤大多以精神症状、视觉障碍和嗅觉减退为首发症状，9例行冠状切口，4例行半冠状切口，分块切除肿瘤，5例翼点入路，1例纵裂入路。1例眶上入路，SimpsonⅠ级切除6例。SimpsonⅡ级切除13例，Simpson级切除1例，预后良好，1例复发。随访时间1～6年（平均3．1年），术前术后均保留嗅觉的为2例，精神状态改善18（91％）和视力障碍改善的15（75％）。1例（5％）复发再次手术。结论术式的选择取决诸多因素，预后取决于手术中的组织保护。

Objective To investigate the treatment and follow - up of olfactory groove meningioma. Methods The linical situation and follow- up of 20 cases were analyzed retrospectively. Results The first symptoms of olfactory groove meningioma were mental symptom, depraved vision or reduced smelling. The tumour was resected via a double frontal approach in 9, a pterional route in 5, a unilateral frontal approach in 4 and via a supraorbital approach in 1 patients. Extent of tumour resection according to Simpson＇s classification system was grade Ⅰ in 6 patients,grade Ⅱ in 13 patients and grade Ⅲ in 1 patient. After a mean follow - up period of 3.1 years （ range 1 - 6 years）. Olfaction was preserved in 2 patients in whom pre - and postoperative data were available. Mental and visual disturbances improved in 91% and 75% of cases,respectively. One recurrences were observed and had to be reoperated. Conclusions The election of Microsurgical Treatment made decision by multiple factor. Prognosis made decision by tumour＇s condition and conservation of brain tissue during operation.