额外侧入路切除鞍结节脑膜瘤32例

Tuberculum seilar operation by frontolateral approach（32 cases report）

目的探讨额底外侧入路切除鞍结节脑膜瘤的手术方法。方法对采用经额底外侧入路手术的32例鞍结节脑膜瘤患者的临床资料进行回顾性分析，采用Simpson分级来评估肿瘤的切除程度。结果肿瘤SimpsonⅠ级切除25例，Ⅱ级切除5例，Ⅲ级切除2例。术后发热4例，脑脊液鼻漏1例，电解质紊乱及血糖升高5例，视力减退2例。无手术死亡。术后随访1—28个月，平均18个月，未见肿瘤复发。结论额底外侧入路切除鞍结节脑膜瘤皮肤切口小，颞肌损伤轻，额窦完整性好，术后嗅神经保留率高，视力改善明显，值得进一步推广。

Objective To summary the methods in removing the tuberculum sellar menigiomas through frontolateral approach. Method 32 tuberculum sellar menigioma patients by frontolateral approach in the last 2.5 years in Beijing Tiantan Hospital were analyzed retrospectively. Simpson score were used to evaluate the tumor resection. Results Simpson score Ⅰ in 25 cases, Ⅱ in 5 cases, Ⅲ in 2 cases. Fever in 4 cases; Cerebrospinal fluid rhinorrhea in 1 case; electrolyte disturbances and hyperglucoses in 5 cases; visual deterioration in 2 cases. No dead patient was found. Follow up time was 1 - 28 months, mean 18 months. No recurrent tumor was observed. Conclusions The frontolateral approach has the advantage of shorter incision, less temporal muscle damage, integrity of frontal sinus, more olfactory nerve reservation, and better visual improvement.