上斜坡肿瘤经眶颧-颞极入路切除的探讨

Orbitozygomatic Temporopolar Approach for Removal of Involving tke Upper Clival Tumors

目的总结眶颧-颞极入路应用的经验，以改善累及上斜坡肿瘤的治疗效果。方法回顾性分析7年间经眶倾-颞极入路治疗的上斜坡肿瘤21例，其中脑膜瘤14例，颅咽管瘤3例，脊索瘤2例，垂体瘤2例。结果全部术后恢复良好，无手术死亡。肿瘤全切除12例（57．1％），次全切除6例（28．6％），大部切除3例（14．3％）。术后发生颅神经损伤并发症7例（33．3％），其中遗留永久性颅神经麻痹3例。结论该人路具有扩大显露范围、减少脑组织牵拉等优点。在选择恰当的病例中可明显提高全切除率，减少术后并发症和降低手术死亡率。

Objective We presented our preliminary experience of the orbitozygomatictemporopolar approach in cases of upper clival tumors in order to raise the total removalrate and to improve operative results. Methods A retrospective analysis of 21 patients withupper clival tumors operated from 1991 to 1998, including meningioma in 14 cases, chordomain 2 cases, craniopharyngioma in 3 cases, and pituitary adenoma in 2 cases. Res'Its Therewere a good postoperative result in all patients without postoperative death. Total excisionof the tumors was documented by postoperative MR in 12 patients (57.1%), nearly totalremoval in 6 cases, and partial removal in 3 cases. Postoperative1y, cranial nervecomplications occurred in 7 patients (33.3%) with permanent worsening function of thecranial nerve in 3 cases. Conclusion The adventages of the cranial base approach includeextensive exposure and minimal retraction of the brain. It has increased the total removalrate with a low operative complication and mortality rate in selected cases.