前纵裂入路切除鞍结节脑膜瘤18例临床分析

Removal of 18 cases of tuberculum sellae meningiomas by anterior interhemispheric approach

目的总结经前纵裂入路切除鞍结节脑膜瘤的手术效果。方法回顾性分析前纵裂人路切除鞍结节脑膜瘤18例患者临床资料。结果根据Simpson分级，手术切除1级5例，2级10例，3级3例。15例术后随访6个月至7年，平均3．1年，恢复正常生活和工作6例，术后症状较术前改善6例，视力较术前无明显变化者3例，中度致残2例，死亡1例。结论前纵裂人路对向前向上方生长的大型鞍结节脑膜瘤暴露充分，减少了对额叶的牵拉，手术效果满意。

Objective To summarize the surgery effect of removal of tuberculum sellae meningiomas by ante- rior interhemispheric approach. Methods The data of 18 cases of removal of tuberculum sellae meningiomas by ante- rior interhemispheric approach were analyzed retrospectively. Results Simpson grade I resection was achieved in 5 cases;grade II in 10 cases and grade III in 3 cases. 15 patients were followed up for 6 months to 7 years,3.1 years on average. 6 patients recovered normal ability in work and life, 6 patients＇ symptom was improved after sugery, 3 pa- tients＇ postoperative visual acuity remained unchanged, 2 patients got the result of medium disability and 1 patient died. Conclusion Large tuberculum sellae meningiomas that grows anteriorly and superiorly can be well exposed through anterior interhemispheric approach, the amount of page pull is reduced, so the satisfactory sugical effect can be achieved.