海绵窦区肿瘤的显微外科治疗

Microsurgical treatment for cavernous sinus tumors

目的观察海绵窦区肿瘤临床特征和手术治疗效果。方法对我院2000年1月～2007年12月住院的36例海绵窦区肿瘤进行回顾性分析并随访。结果36例均为良性肿瘤,其中神经鞘瘤15例,脑膜瘤10例,海绵状血管瘤5例,表皮样囊肿3例,神经纤维瘤2例,黑色素瘤1例。手术治疗33例,其中全切除25例,次全切除7例,部分切除1例,无手术死亡病例。术后脑神经功能好转6例,出现新的脑神经功能障碍或功能障碍加重者15例。随访3～6个月,未见肿瘤复发。结论海绵窦区肿瘤多为良性肿瘤,好发于中年女性。海绵窦区良性肿瘤的手术治疗预后良好。

Objective To summarise the clinical features and microsurgical therapeutical effect on cavernous sinus tumors.Methods Clinical data of 36 hospitalized patients with cavernous sinus tumor from Jan 2000 and Dec 2007 was analyzed retrospectively.Results The study cohort consisted of 15 cases of schwannomas,11 meningiomas,5 cavernous haemangiomas,3 epidermoid cysts,2 neurofibroma,and 1 melanoma.Of all the 36 cases,33 underwent microsurgical treatment aimed at radical excision,one patient with cavernous haemangioma received γ-knife therapy,and 2 cases of meningioma received no treatment.The tumor was totally removed in 25 cases,subtotally removed in 7,partially removed in one,with no surgical mortality.After the operation,the cranial nerve function got improved in 6 cases and deterioration or newly-occurred cranial nerve dysfunction in 15.The patients receiving microsurgical treatment were followed up for 3 to 6 months postoperatively.No relapse occurred.Conclusion Most cavernous sinus tumors are benign and commonly occur in women.If the surgical approach is appropriately selected and the microsurgical technique is skillfully performed,the outcome of the cavernous tumor is quite good.