眶上锁孔入路技术在鞍区肿瘤手术中的初步应用

Application of supraorbital keyhole approach in the resection of sellar tumors

目的探讨眶上锁孔入路技术在鞍区肿瘤手术中的应用价值、手术技术及其适应证。方法回顾分析我科采用经眉弓切口的眶上锁孔入路技术治疗的15例鞍区肿瘤病人临床资料,其中男性9例,女性6例。术前主要症状为视力视野障碍及头痛。病变性质包括脑膜瘤10例,颅咽管瘤3例,垂体瘤2例。术前MRI显示肿瘤最大径20～40mm。结果本组15例病人中全切除13例,术前视力减退的13例病人中12例视力均有不同程度的改善。术后病人恢复快,没有与入路相关的术后并发症。结论眶上锁孔入路是一种安全、有效的微侵袭手术。合适病例的选择和细致的显微神经外科手术操作技术是手术顺利完成的必要条件。

Objective To evaluate the skills, indications and advantages of supraorbital keyhole approach in the resection of sellar tumors. Methods Fifteen patients （9 males, 6 females） with sellar tumors （10 meningiomas, 3 craniopharyngiomas, 2 pituitary tumors） with the maximal diameter of 20-40 mm were treated with tumor removal through supraorbital keyhole approach. Before the operation, the most common symptoms in these patients were visual dysfunction and headache. Results Complete tumor removal was achieved in 13 patients; 12 of 13 patients with visual dysfunction were improved. There were no approach-related complications post-operatively. Conclusion The supraorbital keyhole approach proved to be a safe, effective and minimal invasive technique. Selection of appropriate cases and careful microsurgical procedure are crucial for a successful operation.