经颅开眶眼球后肿瘤切除手术探讨

Transcranial retrobular tumor resection: surgical techniques

目的介绍经颅开眶切除眼球后肿瘤手术技术经验及预后。方法回顾总结了经颅手术切除眶内肿瘤13例临床资料,探讨手术过程中保留视力,美容重建等难点和技巧。结果其中血管瘤8例和1例视神经鞘脑膜瘤全部切除,2例视神经鞘脑膜瘤次全切,1例假性肿瘤和1例错构瘤部分切除;随访7例（6例失去联系）,其中6例术前突眼视力下降3~6个月内均恢复,1例突眼眼外展未恢复。结论经颅眶入路可根据肿瘤位置适当调整手术入路,更好的暴露眼眶内容物及肿瘤,能较好地保护眶内容物,基本不影响容貌。

Objective The surgical treatment and curative effect of transcranial subfrontal unroofing retrobular tumor resection are introduced and the prognosis is discussed.Methods The clinical data of 13 patients with retrobular tumors treated in our department were collected retrospectively.All the patients underwent surgery through subfrontal unroofing approach to discuss the surgical challenges,which involved tumor removal,visual function preservation and cosmetic reconstruction.Results Total resection of the tumors was achieved in 9 cases（ 8 angioma and 1 optic nerve neurinoma）,subtotal resection in 2 optic nerve neurinoma cases,and the partial resection in 1pserdotumor and 1 hamartoma.Seven patients were followed-up for 6 months（ 6 patients was lost during follow-up）.Of 7 patients,the visual acuity was improved in 6 patients and remained unchanged in 1 patient.Conclusion Retrobular tumor can be treated safely by transcranial approaches which provides a better exposure of the orbital cavity and tumors.