蝶骨嵴脑膜瘤的显微手术治疗

Long-term follow-up outcomes of microsurgery for sphenoid ridge meningiomas

目的探讨蝶骨嵴脑膜瘤的显微手术治疗效果。方法2000年1月至2012年12月收治经病理证实的26例蝶骨嵴脑膜瘤患者,其中内侧型12例、中部型6例、外侧型8例;采用显微手术切除肿瘤,其中翼点开颅18例,额颞断颧弓开颅6例,额眶颧开颅2例。结果肿瘤全切18例,大部分切除5例,部分切除3例。22例患者获得随访,4例失访;随访时间3-168月,平均70月;复发5例,复发率为19.2%,再次手术3例,保守治疗1例,伽玛刀治疗1例。结论采用显微手术切除肿瘤为蝶骨嵴脑膜瘤的首选治疗方法,个体化的手术入路有助于全切肿瘤,精细操作可减少术后并发症的发生率。

ObjectiveTo explore the effectiveness of microsurgery for patients with sphenoid ridge meningiomas（SRMs）.MethodsTwenty-six patients with SRMs received microsurgery from January 2000 to December 2012.Two hypervascular SRMs received endovascular treatment before microsurgery.ResultsOf 26 patients with SRMs,12,6 and 8 patients were medial,middle and lateral third SRMs,respectively.Total resection was achieved in 18 patients,subtotal in 5 and partial in 3.All symptoms resolved and no patient died after operation.New oculomotor paralyses,pulmonary infections and intracranial infections occurred in 10,3 and 2 of 26patients after operation,respectively.Twenty-two patients were followed up for 70 months（range,3 to 128 months）,and the outcomes showed that 5 patients recurred,of whom,3 were treated by re-operation,1 by conservative treatment and 1 by gamma knife.ConclusionsTotal resection of SRMs by microsurgery is a good treatment method for patients with SRMs.Long-term follow-up should be performed on the patients with residual tumors.