头面部颅外脑膜瘤11例分析

Extracranial meningioma of head and face

目的探讨头面部颅外脑膜瘤的临床特征及诊断、治疗特点。方法对11例头面部颅外脑膜瘤的临床资料进行回顾性的分析、总结。结果肿瘤病变部位:眶内5例,鼻腔2例,颞窝、颞下窝各1例,顶枕部2例。手术入路颅面联合入路2例,眶外侧入路1例,鼻侧切开术2例,眶内容物剜除术1例,颞窝、颞下窝入路各1例,额眶入路1例,顶枕部肿瘤表面入路2例。11例均行手术治疗。全切肿瘤9例,近全切肿瘤2例,无手术死亡及严重并发症发生。1例术后行放疗,1例2年后复发行X刀治疗。随访期6个月至7年均存活。结论头面部颅外脑膜瘤是少见的病例,主要表现出所在部位的局部症状,对不易活检的部位,术前定性诊断困难。治疗以手术为主,全切预后较好。

Objective To study the clinical features, diagnosis and treatment of extracranial meningioma of the head and face. Methods Clinical data of 11 patients diagnosed as extracranial meningioma of head and face were analyzed retrospectively. Results As for the location of the tumor, 5 were in the orbit, 2 in the nasal cavity, 1 in the temporal fossa, 1 in the infratemporal fossa, and 2 in the extracranial parietooccipital part. All the patients were treated with surgery. The surgical approaches included combined craniofacial approaches （2 cases）, extra-orbital approach （1 case）, lateral rhinotomy （2 cases）, intraorbital content evidement （ 1 case）, temporal approach （1 case）, infratemporal approach （1 case）, frontal orbit approach （1 case）, and approach through the tumor surface of the parietooccipital meningioma （2 cases）. The tumors were totally resected in 9 cases and subtotally resected in 2. Neither death nor severe complications occurred during operation. One case was treated with radiotherapy after operation. One case recurred two years after operation and was then treated with X-knife. All the：patients were alive 0. 5 to 7 years after follow-up postoperatively. Conclusion The extracranial meningioma of head and face is rare and the diagnosis is difficult to be confirmed before operation. Surgery with en bloc removal is the major choice with good prognosis.