蝶骨嵴脑膜瘤的临床特征及显微外科治疗(附27例报告)

Clinical features and microsurgery treatment of the sphenoid ridge meningioma(a report of 27 cases)

目的探讨蝶骨嵴脑膜瘤的临床表现和显微外科治疗效果。方法回顾性分析武汉大学人民医院2005年5月—2010年5月收治的27例蝶骨嵴脑膜瘤的临床资料。结果临床表现为颅内压增高17例,视力障碍14例,癫痫5例。影像学检查巨大型(直径>7.0cm)2例,大型(4.6～7.0cm)16例,小型(≤4.5cm)9例。肿瘤全切除20例(74.1%),次全切除5例(18.5%),部分切除2例(7.4%)。1例术后放弃治疗死亡,余病例无严重并发症发生。结论蝶骨嵴脑膜瘤患者的临床症状不典型,诊断主要依据CT和MR。娴熟的显微操作技术、选择正确的手术入路以及术中神经和血管保护是手术成功的关键。

Objective To investigate the manifestations and treatment methods of sphenoid ridge meningioma （SRMs）.Methods The medical records of 27 cases with sphenoid ridge meningioma treated at People＇s Hospital of Wuhan University from May,2005 to May,2010 were reviewed retrospectively.Results Clinical menifestation showed intracranial hypertension in 17 cases,eyseight dysfunction in 14 sases,epilepsy in 5 sases.Imaging esamination showed huge type（diameter7.0 cm） in 2 cases,large type（diameter 4.6～7.0 cm） in 16 cases and small type（diameter≤4.5 cm） in 9 cases.In all of the 27 cases of SRMs,20 cases（74.1%） were totally removed,5 cases（18.5%） were sub-totally removed,2 cases（7.4%） were partially removed.One case was given up post-operation treatment and died;others did not show severe complications. Conclusion The clinical presentations of sphenoid ridge meningioma were un-typical in most patients.The diagnosis was mainly based on CT and MR images.The microsurgery can greatly increase the total resection rate of tumors.Appropriate approach and protection of vessels and nerves play important roles in the whole procedure.