经颅显微切除眶内及眶颅沟通性肿瘤

Microsurgical resection for orbital or orbitocranial neoplasma

目的探讨眶内及眶颅沟通性肿瘤的显微外科治疗方法。方法对32例眶内及眶颅沟通性肿瘤手术治疗患者的临床资料进行回顾性分析。32例中眶内肿瘤21例，眶颅沟通性肿瘤11例，均出现与视器有关的症状。13例采用经额硬膜外入路，另19例采用经翼点入路。结果肿瘤全切27例，大部切除4例，1例未切除。术中15例行颅底重建，均恢复良好。术后无死亡病例。结论眶内及眶颅沟通性肿瘤目前以外科手术治疗为主，采用不同的手术入路及联合入路，在显微镜下切除肿瘤，可以增加肿瘤全切的可能性，能直接改善手术治疗效果；颅底重建对于预防脑脊液漏及颅内感染等并发症的发生有关键作用。

Objective To find out a sesirable approach through which orbital or orbitocranial neoplasma can be resected more effectively. Methods A retrospective study was made on microsurgical resection of 32 cases orbital or orbitocranial neoplasma treated. All patients showed malfunction of optic organs. Microsurgical techniques and different approaches were used to remove neoplasmas. Results Twenty-seven cases received total removal,4 cases subtotal resection, 1 case no resection and 15 cases＇ skull bases were reconstructed.No postoperative morbidity was found. Conclusions Microsurgical techniques as well as disirable or combined approaches may increase the possibility to resect the total neoplasma and improve clinical results.The reconstruction of skull base should be much emphasized on preventing complications.