海绵窦海绵状血管瘤的显微手术治疗策略

Microsurgical treatment regimens of cavernous sinus hemangioma

目的探讨海绵窦海绵状血管瘤（CSH）的手术治疗方法。方法回顾分析吉林大学第一医院自2008年1月至2012年1月收治的经手术和病理证实的CSH临床资料，共17例。17例中男6例，女11例，年龄平均48．5岁。结果17例中全切14例，大部切除3例，无手术死亡病例。根据影像学检查结果，全切病例未见肿瘤复发；大部切除者经放疗后残留肿瘤无进展。术中颅神经解剖保留情况：动眼神经均解剖保留，外展神经12例，三叉神经15例；部分神经解剖保留病例在术后3～6个月神经功能不同程度恢复。结论根据肿瘤的体积和生长方向选择合适的手术入路，结合娴熟的显微外科技术和恰当的切除方法，可以最大限度的减少术中出血并全切肿瘤，降低神经功能缺失程度，提高远期术后生存质量。

Objective To analyze the microsurgical treatment regimens of cavernous sinus hemangioma. Methods The microsurgical experiences were reviewed and analyzed for 17 cases of operatively and pathologically confirmed cavernous sinus cavernous hemangioma at our hospital from January 2008 to January 20｜2. There were 6 males and ll females with an average age of 48.5 years. Results Among them, there were total （n = 14） and subtotal （ n = 3） resection. And there was no occurrence of postoperative mortality. According to the results of imaging follow-up, total resection cases had no recurrence while subtotal residual tumor was progression-free after radiotherapy. Oculomotor, abdueens and trigemiual nerves retained varying degrees of neurological function at 3 -6 months postoperation. Conclusion Based on the size of tumor and growth direction, appropriate surgical approaches may be selected. And a combination of skilled mierosurgical techniques and proper resection may reduce bleeding and facilitate total tumor removal so as to reduce the degree of neurological deficits and improve the long-term postoperative quality-of-life.