内侧型蝶骨嵴脑膜瘤的微创外科手术治疗

Minimally invasive surgical treatment of medial sphenoid ridge meningioma

目的:探讨内侧型蝶骨嵴脑膜瘤的微创外科治疗策略及方法。方法:回顾分析23例内侧型蝶骨嵴脑膜瘤病例的临床资料、微创外科治疗及手术过程、疗效及预后情况。结果:所有病例通过微创神经外科手术切除。simpsonⅠ、Ⅱ级切除20例,Ⅲ级3例。出现动眼神经麻痹2例,尿崩2例,视力恶化1例,轻瘫3例,肌力术后1个月均恢复,脑血管痉挛并脑梗死1例,无死亡病例。结论:个体化的术前评估,微创外科手术技术的应用能提高肿瘤的全切率及疗效,在切除肿瘤的同时尽可能保护患者的神经功能。

Objective To investigate the resource and technique of minimally invasive surgical treatment for medial sphenoid ridge meningioma.Method Retrospective analysis of the clinical data,surgical treatment and minimally invasive surgical procedure,efficacy and prognosis of 23 cases of medial sphenoid ridge meningioma.Results All patients were treated with the minimally invasive surgical treatment.The tumors were totally removed in 20 cases（simpson Ⅰ,Ⅱ grade）,subtotally removed in 3 cases（simpson Ⅲ grade）.Oculomotor palsy occurred in 2 cases,2 cases of diabetes insipidus,visual deterioration in 1 case,3 cases of paresis,muscle strength recovered after 1 month,cerebrovascular spasm and cerebral infarction in 1 case,no death in this group.Conclusion Individualized preoperative evaluation,the application of minimally invasive surgical techniques can improve the rate of total resection of tumor and effect,protecting neurological function while in the resection of the tumor as possible.