内侧型蝶骨嵴脑膜瘤显微外科治疗体会

Clinical experience of microsurgical treatment of 20 patients with internal sphenoidal ridge meningioma

目的 :探讨内侧型蝶骨嵴脑膜瘤手术治疗方法。方法 :本文复习了 2 0例内侧型蝶骨嵴脑膜瘤的临床资料 ,重点讨论了手术方法。结果 :实现脑膜瘤镜下全切 17例 ,大部分切除 3例 ,无手术死亡 ,疗效满意。结论 :认为在熟悉掌握毗邻显微解剖结构的基础上 ,采用显微外科技术 (CUSA) ,结合术前超选栓塞颈外动脉系统的肿瘤供应支 ,可提高肿瘤全切率 ,减少对周围重要神经结构的损伤 ,降低死亡率。但对明显侵犯下丘脑、海绵窦等重要结构的肿瘤 ,手术难度较大者 。

Objective To study effective surgical treatment method for internal sphenoidal ridge meningioma.Method Review clinical data of 20 cases with resection of internal sphenoidal ridge meningiomas and mainly discuss surgical treatment method.Results Among them,total resection of the tumor are achieved in 17 cases and most partial resection in 3 cases with no death,surgical effects are satisfactory.Conclusion Good understanding of the microanatomy about surgical approach with application of microsurgical technique,CUSA and surperselective embolism of tumor nutrient arteries from external carotid artery system preoperatively can greatly increase total resection rate of tumor,avoid potential injury to adjacent important structures,reduce mortality.However,palliative operations should be carry out sometimes for the tumors apparently invading surrounding important tissues such as hypothalamus,cavermous sinus and so on.