眶上锁孔入路在鞍结节脑膜瘤手术中的应用

The Supraorbital Keyhole Approach for Removing Tuberculum Sellae Meningiomas

背景与目的:鞍结节脑膜瘤手术是神经外科中有挑战性的难题。本研究探讨眶上匙孔入路在切除小型鞍结节脑膜瘤手术中的应用价值、手术技巧及其适应证。方法:回顾分析瑞金医院神经外科采用眶上匙孔入路治疗的21例鞍结节脑膜瘤患者的临床资料。结果:21例患者出院时均恢复良好,肿瘤全切除20例(93.3%),术后视力改善者19例(86.7%),没有与手术入路相关的严重术后并发症。结论:对于有经验的神经外科医生来说,大多数小于3cm的鞍结节脑膜瘤可以通过眶上匙孔入路切除;尽管开颅骨孔小,但可提供足够的空间进行颅内操作切除肿瘤,并保护脑和其他重要结构;手术全切除率高,并发症少,手术效果良好。

BACKGROUND ＆ OBJECTIVE： The resection of tuberculum sellae meningiomas is a challenge for neuro -surgerists. To evaluate indications, surgical techniques and advantages of resection of tuberculum sellae meningiomas via supraorbital keyhole approach. METHODS： A retrospective analysis of the clinical data of 21 patients with tuberculum sellae meningioma resected via supraorbital keyhole approach was performed. RESULTS： Among 21 patients, total tumor removal was achieved in 20 patients （93.3%）and pre-operative visual dysfunction improved in 19 patients （86.7%）. No major postoperative complications were observed. CONCLUSION： For experienced neurosurgeons, tuberculum sellae meningiomas with the size of less than 3cm can be removed completely and safely via supraorbital keyhole approach.