纵裂入路显微外科治疗大型嗅沟脑膜瘤的手术方法及疗效观察

Microsurgery through coronal skin flap,and interhemispheric approach for large bilateral olfactory groove meningiomas(a report of 11 cases)

目的:探讨经纵裂入路切除嗅沟脑膜瘤的手术方法及治疗效果。方法:回顾性分析我院神经外科2004年3月至2011年4月利用显微外科手术切除的11例大型双侧嗅沟脑膜瘤患者的临床资料。11例大型双侧嗅沟脑膜瘤多以头痛、嗅觉障碍为首发症状。手术均采用纵裂入路,不打开额窦。结果:肿瘤Simpson 1级切除3例,Simpson 2级切除6例,Simpson 3级切除2例,无手术死亡病例,随诊疗效满意。结论:经纵裂入路切除嗅沟脑膜瘤有很多优点,可以作为大型嗅沟脑膜瘤手术切除的一种选择术式。

Objective：To investigate the operative method to treat the large bilateral olfactory groove meningiomas and its curativeeffect. Methods：The clinical data of 11 patients with large bilateral olfactory groove meningiomas treated by microsurgery through coronal skin flap and interhemispheric approach from May,2004 to March ,2011 were analyzed retrospectively. The primary symptoms in the 11 patients with large bilateral olfactory groove meningiomas were headache and smell disorders. Results： Simpson grade 1 resection was achieved in 3 cases, grade 2 in 6 cases and grade 3 in 2 cases. No patient died from the microsurgery. The tumors did not recurred in all the patients during following up from 1 to 7 years. Conclusion： Interhemispheric approach has many advantage, on the large bilateral olfactory groove meningioma is a good selection.