额底纵裂入路切除颅咽管瘤的临床研究

Clinical study on craniopharyngioma resection via fronto-basal interhemisheric approach

目的探讨额底纵裂入路切除颅咽管瘤的手术方法、手术特点和疗效。方法回顾性分析31例经额底纵裂入路手术治疗的中线生长型颅咽管瘤患者的临床资料。结果31例患者术中鞍区结构显露良好，肿瘤全切除19例（61．3％），次全切除12例（38．7％）；术后视力视野均得到改善，并发电解质代谢紊乱6例（19．4％），尿崩症15例（48．4％）。结论颅咽管瘤患者采用额底纵裂入路行肿瘤切除术中显露中线结构良好，是治疗中线生长型颅咽管瘤安全有效的手术入路。

Objective To explore the operational methods and effect of craniopharyngioma resection via fronto-basal interhemisherie approach. Methods The clinical data of 31 patients who had underwent craniopharyngioma resection via fronto-basal interhemisheric approach were analyzed retrospectively. Results The saddle area structures of all the 31 patients were revealed well. The tumor total resection was in 19 cases （61.3%）, and the tumor subtotal resection was in 12 cases （38.7%）. The vision and field of vision after surgery were improved. Six cases （19.4%） presented electrolyte disturbance, and 15 cases （48.4%） presented diabetes insipidus. Conclusions The fronto-basal interhemisherie approach can clearly expose the anatomical structures in midline and saddle area. This approach is safe and effective for eraniopharyngioma resection.