神经内镜下手术治疗脑室内胆脂瘤

Neuroendoscopic management for intraventricular epidermoid cyst

目的探讨神经内镜下手术治疗脑室内胆脂瘤的手术技巧和疗效。方法回顾性分析7例神经内镜下手术治疗的脑室内胆脂瘤患者的临床资料。肿瘤主体分别位于侧脑室5例、三脑室2例,合并脑积水5例。结果 7例患者的脑室内胆脂瘤均得到瘤体全切。其中包膜全切2例,包膜部分切除5例;4例患者行三脑室底造瘘术,2例患者行透明隔造瘘术。合并脑积水患者术后脑积水明显改善,无明显手术并发症。平均随访23.4个月,无复发及脑积水加重病例。结论神经内镜下手术治疗脑室内胆脂瘤是一种创伤小、全切率高、安全性高的有效方法,尤其适合合并脑积水的患者;术中同时行三脑室底造瘘或透明隔造瘘可有效缓解脑积水。

Objective To explore the surgical techniques and effects of intraventricular epidermoid cyst treated by operation with neuroendoscope. Methods The clinical data of 7 patients with intraventricular epidermoid cyst treated by operation with neuroendoscope were analyzed retrospectively,which located in 5 of lateral ventricles,third ventricles in 2 and 5 of them with hydrocephalus. Results Total removal was achieved in all cases,condition with hydrocephalus was improvement after the surgery. There was no complication relate to surgery,and no condition get worse and cyst relapse by the follow up. Conclusions Neuroendoscopic procedure is an effective method for intraventricular epidermoid cyst,which is minimally invasive,high total removal rate and high sfaty. Especially suitable for the cases with hydrocephalus,third ventriculostomy and pellucid septostomy during the surgery can effectively relieve the hydrocephalus.