嗅沟脑膜瘤

Olfactory groove meningioma

本文报告了最近八年连续收治的嗅沟脑膜瘤共42例,占同期颅内脑膜瘤4.5％,临床表现以嗅觉障碍最为多见,但多被病人忽视,其次为视力障碍 就诊时肿瘤最大径超过6cm 者占2 3以上 本组肿瘤全切除40例(95％),次全切除2例 无手术死亡 平均随访5.8年,效果满意

Fourty-two pathological verified olfactorygroove meningioma were operated from May1982 to May 1990 in Beijing Neurosurgical Ins-titute (BNI). That accounted for 4. 5% ofall intracranial meningiomas surgically treatedin BNI during the same period: Impairmentof smell was the mostly common sign butwas often neglected by patients themselves.Poor vision, including 5 blindness. was anothermain clinical sign. In accordance to measurementby CT or MRI. 30 cases were larger than6 cm in diameter. For these huge and bilateraly-growing tumors. bifrontal craniotomy and interhe-mispherhc approach was abopted. Weemphasized the following points for operation:(1) piecemeal removal rather than en block;(2) always pulling the tumor forward and upward(3) If internal carotid artery or anteriorcerebral artery tightly pulling the tumor envelo-ped by a small piece of tumer. it is wiseto leave it alone: (4) Microsurgical techniqeis utmost necessary. Results: total removal reached to 95%.subtotal only in 2 cases. There was nodeath rate. Transient mental disturdancesoccurred postoperatively in 17 cases. Cerebralspinal fluid rhinorrhea was encountered in3 cases. Viz. 1 originated from openedfrontal sinus. 2 from over charred dural atta-chment of the tumor. All of them werecured by conservative. Follow-up study wasobtained in 26 cases with a duration from2 to 9 years. Most of them recoveredsatisfactory except in the cases with preope-rative poorest vision or blindness. From abovedata the authors consider that early diagnosisand promation the therapeutic sffects areveryimportant in the future work.