眶上锁孔入路手术切除前颅底脑膜瘤的临床效果

Microsurgery through supraorbital keyhole approach for anterior cranial fossa meningiomas

目的探讨经眶上锁孔入路手术切除前颅窝底脑膜瘤的临床效果。方法自2010年1月至2015年1月,我们经眶上锁孔入路锁孔手术切除前颅窝底脑膜瘤24例(锁孔组);同期采用传统额下入路手术切除前颅窝底脑膜瘤25例(传统组)。结果锁孔组与传统组性别、年龄、病程、肿瘤大小、术中输血率、肿瘤全切率及并发症发生率等均无统计学差异(P>0.05),但是锁孔组手术时间(指切皮开始到缝合皮肤结束为止)、术中出血量及住院时间较传统组明显减少(P<0.01)。锁孔组术后1例出现颅内感染,给予抗感染治疗后痊愈出院。传统组术后1例出现颅内感染,1例发生脑脊液漏,给予抗感染等对症治疗后痊愈出院。两组均无死亡病人。结论与传统额下入路手术相比,经眶上锁孔入路手术切除前颅窝底脑膜瘤效果满意,并具有手术时间短、术中出血量少、住院时间短等优势。

Objective To explore the clinical effects of the microsurgery through supraorbital keyhole approach on the anterior cranial fossa meningiomas and its advantages. Methods The clinical data of 24 patients with anterior fossa meningiomas excised by the microsurgery through supraorbital keyhole approach were analyzed and then their surgical outcomes were compared with those in 25 patients with anterior fossa meningiomas excised by microsurgery through subfrontal approach. Results There were insignificant differences in the rates of total resection of the tumor, transfusion of blood and occurrence of major postoperative complications between both the groups. The operative duration [（148.96±34.33）min] and average stay [（6.67± 1.86）days] were significantly shorter, the volume of intraoperative bleeding was significantly fewer in the patients undergoing microsurgery through supraorbital keyhole approach than those in the patients undergoing microsurgery through subfrontal approach （P〈0.01）. Conclusion The curative effects of microsurgery through supraorbital keyhole approach, which has advantages including shorter operative duration, small volume of intraoperative bleeding and shorter average stay on the anterior cranial fossa meningiomas are satisfactory.