经眉上锁孔入路治疗鞍区病变

Keyhole craniotomy for sella lesions through a superciliary skin incision

目的采用经眉上锁孔入路这一微创手术方法,治疗幕上动脉瘤及鞍区颅咽管瘤.方法平行于眉毛在眉上切开皮肤,与眉毛长度一致,在一个直径2.5 cm的圆形骨瓣内进行手术.结果切除3例大型颅咽管瘤及夹闭3例脑动脉瘤(1例前交通支动脉瘤、2例后交通支动脉瘤),随访1～3个月,与常规翼点入路比较其疗效相一致.结论经眉上锁孔入路结合现代神经麻醉,脑脊液的引流以及显微外科技术,治疗幕上脑动脉瘤及鞍区肿瘤是安全有效的途径.

ve To treat superatentorial aneurysms and craniopharyngiomas by the transorbital keyhole approach. Methods An incision was made at the upper edge of the eyebrow, paralleling and equalling the eyebrow. The operations were carried out through a circle bone flap whose diameter was 2.5 cm. Results Three large craniopharyngiomas were removed and 3 aneurysms were clipped (1 was anterior communicating aneurysm and the other 2 were posterior communicating aneurysms). After the follow-up of 1 - 3 months after the surgery, the results were favorable compared with those of standard peri tonal craniotomy. Conclusion The transsuperciliary keyhole craniotomy, together with the modern neuroanesthesia, cerebrospinal fluid drainage, and microsurgical techniques, is a safe approach in treating superatentorial aneurysms and sellar regions craniopharyngiomas.