经眉弓眶上锁孔入路切除鞍区病变

Supraorbital keyhole approach for excision of the sellae region lesion

目的探讨经眉弓眶上锁孔入路治疗鞍区病变的显微手术技术。方法采用经眉弓皮肤切口,做2.0cm×2.5cm包分眶板在内的额下骨窗;应用显微手术技术处理鞍区病变20例。结果20例鞍区病变采用经眉弓眶上锁孔入路愈,包括垂体瘤9例,颅咽管瘤4例,后交通动脉瘤1例,鞍膈脑膜瘤1例,鞍结节脑膜瘤1例,嗅沟脑膜瘤1例,脊神经损伤2例,1例出现一过性尿崩症,3例出现电解质紊乱,所有20例均经随访,到目前为止,无一例复发。结上锁孔入路可明显减少手术创伤,同时能提供鞍区足够的手术空间,并能有效地处理病变。

Objective To study microsurgery technique with supraorbital keyhole approach through superciliary arch for treatment of the sellae region lesions.Method With microsurgery technique,the skin incision through superciliary arch,the intra-frontal bone window including orbital margin and part of orbital plate,20patients were treated.Result All the patients were cured using the supraorbital keyhole approach through superciliary arch technique,including9cases of pituitary tumor,4cases of craniopharyngioma,1case of posterior communicating artery aneurysm,1case of diaphragma sellae meningioma,1case of tuberculum sellae meningioma,1case of olfactory sulus meningioma,1case of chordoma,2cases of optic nerve injury,1case had transient diabetes insipidus,3cases had electrolyte disorder.All the patients were followed up,no recurrent lesio n could be observed.Conclusion The supraorbital keyhole approach through superciliary arch can obviously diminish the opera-tion-trauma,and has been proven to provide sufficient operating space in the sallae region and treat the lesion efficiently.