翼点入路显微手术切除鞍结节脑膜瘤

Microsurgery of tuberculum sellae meningiomas by pterional approach

目的探讨翼点入路显微外科手术切除鞍结节脑膜瘤的手术技巧和术中注意事项。方法回顾性分析自2001年4月至200年10月我院采用翼点入路显微手术切除43例鞍结节脑膜瘤的临床资料,并对手术技巧加以总结。结果SimpsonⅠ级切除5例,Ⅱ级切除31例,Ⅲ级切除7例。术后视力改善者24例,视力无变化者6例,视力恶化者2例;术后视野缺损恢复者21例;出现一过性尿崩者6例;出现高热、电解质紊乱者2例:死亡1例。结论应用翼点入路显微手术切除鞍结节脑膜瘤,疗效满意。熟悉鞍区的局部解剖和术中对肿瘤周围重要结构的保护是手术成功的关键。

Objective To discuss the intraoperative techniques and announcements ofpterional approach microsurgery of tuberculum sellae meningiomas. Methods The clinical data of 43 patients who were treated with pterional approach microsurgery in our hospital from April 2001 to October 2006 were analyzed retrospectively and the microsurgical techniques were summarized. Results Simpson grade Ⅰ resection was achieved in 5, grade Ⅱ in 31 and grade Ⅲ in 7. Postoperative visual acuity was improved in 24, remained unchanged in 6, and deteriorated in 2 ; 21 patients showed good improvement of campus visualis after operation; 6 patients had transient diabetes insipidus; 2 patients had hyperpyrexia and electrolyte disturbances; and 1 patient died. Conclusion Satisfactory curative effect can be achieved by using pterional approach microsurgery of tuberculum sellae meningiomas. The familiarity of the anatomy of sellar region and the intraoperative protection to the important structures around the tumor are the key points to successful surgery.