海绵窦畸胎瘤的诊断与手术治疗

Diagnosis and surgical treatment of cavernous sinus teratoma

目的探讨海绵窦畸胎瘤的临床诊断和治疗方法。方法回顾性分析3例海绵窦畸胎瘤的临床资料。均采用翼点硬膜下入路显微神经外科手术切除肿瘤,其中2例为海绵窦内畸胎瘤,1例为海绵窦外侧壁畸胎瘤。结果肿瘤均全切除,术后病理检查示均为成熟性畸胎瘤,无手术死亡。1例术前自发破裂的海绵窦内畸胎瘤术后加行放疗。随访6个月-3年肿瘤均无复发。结论海绵窦肿瘤术前影像学评估非常重要,对于良性海绵窦畸胎瘤,积极的显微手术切除一般可获得满意的治疗效果。

Objective To investigate the clinical diagnosis and treatment of cavernous sinus teratoma. Methods Three patients with cavernous sinus teratoma （2 intracavemous teratomas, 1 teratoma of the lateral wall of the cavernous sinus） treated by microsurgical techniques via pterional subdural approach were analyzed retrospectively. Results Total removals were achieved in the 3 cases. No surgical mortality occurred. Three mature teratomas were verified with pathological reports. One patient with preoperative spontaneously ruptured intracavvrnous teratoma received radiotherapy after operation. Follow-up period was from 6 months to 3 years, there was no evidence of tumor recurrence. Conclusion The preoperative imageological evaluation of cavernous sinus tumor is significant. Most of cavernous sinus teratoma is benign, and the therapeutic effect of total removal by microsurgical technique is ideal.