神经导航辅助下显微手术治疗颅底中央区肿瘤

Neuronavigator-assisted Microsurgery for Tumors in Central Regions of Skull Bases

目的探讨神经导航系统在颅底中央区肿瘤显微切除术中的应用及其优越性。方法对36例颅底中央区肿瘤患者应用神经导航系统辅助下实施显微手术,术前将患者影像学信息导入神经导航系统进行解剖三维重建,并依据肿瘤部位应用神经导航系统设计个体化的手术切口,术中对手术入路、肿瘤及其周围重要解剖结构准确定位,判断肿瘤切除程度。结果本组病例神经导航注册误差为0.6～2.3mm,平均(1.1±0.3)mm。36例患者中肿瘤全切26例,次全切除10例(术后1月内均行γ刀治疗,死亡1例)。术后患者临床症状均得到改善或消失。结论在颅底中央区肿瘤显微手术中应用神经导航系统能准确定位肿瘤与周围重要解剖结构,并引导手术操作,安全、准确地切除肿瘤,提高手术疗效,减少手术并发症的发生。

Objective To explore the application of neuronavigator-assisted microsurgery to the tumors in the central regions of skull bases and its merits. Methods The neuronavigator-assisted microsurgery for the tumors in the central regions of skull bases was performed in 36 patients.The individualized operational plan before the operation was designed according the anatomical 3- dimensional reconstruction imaging by the neuronavigation system receiving the imaging information in the patients with the tumors in the central reghms of skull bases. Results The tumors were totally removed in 26 patients and subtotally in 10, who were treated by γ knife after the operation. The fiducial error was （1.1 ±0.3）mm （0.6-2.3 mm）. The clinical symptoms were improved or disappeared in all the patients. One patient died after the operation. Conclusions The application of neuronavigator-assisted microsurgery to the tumors in the central regions of skull bases is helpful to aecurate localization of the tumors and important structures around the tumors. The curative effect ean be enhanced and the operative complications can be reduced by the neuronavigator-assisted microsurgery in the patients with tumors in the central regions of skull bases.