经翼点入路显微手术切除小儿颅咽管瘤20例

20 cases of microsurgery with pterional approch in children with craniopharyngioma

目的 探讨提高手术根治颅咽管瘤的方法。方法 对 2 0例颅咽管瘤 ,均在全麻下行翼点入路 ,采用显微外科技术 ,根据肿瘤的位置 ,采用视交叉前间隙、颈内动脉和视神经间隙及颈内动脉外侧等间隙切除肿瘤。结果 全切除 16例、近全切除 3例、大部切除 1例。近期明显好转 14例、改善 4例、无变化及死亡各 1例。半年以上随访 18例 ,能正常生活者 16例 ,生活需人照顾 2例。结论 翼点入路手术能满足鞍区多种类型颅咽管瘤的显露 ,能提高肿瘤全切率及治愈率。

Objective To summarize an improved surgical approach for cranioparyngioma.Methods Twenty patients with craniopharyngioma were operated under general anesthesia by microsurgery of pterional approach.Based on the locations of the tumors,dissection was performed in different spaces,like the prechiasmatic opticocarotid,carotid tentorial space or lamina terminals.Results 16,3 and 1 patients underwent toal, subtotal and partial resection respectively,of whom 14 significantly improved,4 improved,1 remained unchanged and 1 died.a follow up lasting over 1/2 years showed that 16 patients were able to live normally and 2 needed to be taken care of.Conclusions Pterional approach could meet the need for revealing many kinds of craniopharyngioma,and,therefore,increase total removal and curative rate. [