颅眶沟通性肿瘤的诊断与治疗

Diagnosis and treatment of neoplasms involving the cranio-orbital region

目的 探讨颅眶沟通性肿瘤的诊断、治疗及预后。方法 对 16例颅眶沟通性肿瘤的临床表现、病理、神经影像学诊断及手术治疗等进行分析。结果 经额颞眶顶入路手术 11例 ,经翼点入路手术 5例 ,均病理证实。肿瘤全切除 5例 ,近全切除 8例 ,大部切除 3例。脑膜瘤 10例 ,转移癌 4例 ,神经鞘瘤和淋巴瘤各 1例。脑脊液漏和颅神经损伤为主要并发症。本组随访最长 2年 ,肿瘤全切除者均为脑膜瘤病例 ,未见复发 ;近全切除脑膜瘤病例经γ 刀治疗未见肿瘤生长 ;转移癌病例中 1例术后半年死于多发脏器转移。结论 颅眶沟通性肿瘤比较少见 ,手术切除为首选治疗方法。但全切除较困难 ,术后放射治疗或化学治疗对多数病例是必要的。

Objective To study the diagnosis and microneurosurgical treatment of neoplasms involving the cranio orbital region. Methods Clinical manifestations, neuroradiological features, operative technique and postoperative complications in 16 cases of cranio orbital region neoplasms were reviewed. Results Total resection was achieved in 5 cases, and subtotal resection in 8 cases. No operative death was observed. Conclusion The neoplasms involving the cranio orbital region are uncommon. Total resection is difficult in most cases. Postoperative complications are severe and should be avoided if possible.