眶颅沟通肿瘤52例诊治体会

Dignosis and management of tumors with orbito-cranial access

目的 :为了明确眶颅沟通肿瘤的性质和范围以确定手术方法。方法 :从患病的年龄、眼别、病程、视力、疼痛、突眼、眼球运动等情况以及影像学检查来确定肿瘤的性质和病变涉及的范围。结果 :良性肿瘤多有无痛性眼球突出 ,早期视力好 ,晚期有不同程度的视力障碍。疼痛性突眼或疼痛性肿块 ,发展快 ,视力下降较早且显著 ,甚者短期内失明常为恶性肿瘤的临床表现。影响视力的眶内肿瘤多见于神经源性肿瘤、眶内恶性肿瘤和眶尖良性肿瘤。结论 :经眼科入路切除眶内肿瘤往往因手术野小 ,暴露困难而影响肿瘤切除的彻底性。特别是肿瘤向颅内蔓延更不能达到肿瘤全切除 ,唯有经颅眶入路才有利于肿瘤全切除。

Objective:To identify the characteristics and extent of orbitocranial tumor for the selection of operative methods.Methods:According to the valuation of the patients'age,eye's site,course of disease,sight,pain,protruding eyes,movement of eyes,and imageological examination.Localization and identification could of tumors be made.Results:Benign tumors have painless protruding eyes.On the early stage the patients'sight were good,but in the late stage the sight had different level barrier.Painful protruding eyes or painful mass,develop fast,sight drop earlier and distinguighed.Even in short time the patients go blind,which usually prompt clinical manifestation of malignant tumors.In the orbit tumors which infect sight,most of that are neurogenous tumors.Malignant tumors in the orbit,and benign tumors in the top of orbit Because it press nerves.Conclusion:Proceed from ophthalmic operations resected tumors in the orbit aren't thoroughly.Because of its operative field are too small to exopse.Particularly the tumors towards into cranium spread,still more can't get complete resection.Only if pass through cranial-orbito operation is of great abvantage to the tumors whole resection.The Key of via cranial-orbito operation is low site of forehead bone value or low site of forehead tempera bone valve.