神经内镜辅助下经眉弓上锁孔入路治疗鞍区中大型脑膜瘤的效果分析

Resection of large and medium-sized meningiomas in the sellar region via neuroendoscope assisted supraorbital keyhole approach

目的探讨神经内镜辅助下经眉弓上锁孔入路治疗鞍区中大型脑膜瘤的临床效果。方法回顾性分析广州医科大学附属第二医院神经外科自2017年3月至2019年3月采用神经内镜辅助下经眉弓上锁孔入路治疗的13例鞍区中大型脑膜瘤患者的临床资料及手术效果。结果13例患者术中Simpson分级Ⅰ级切除2例、Ⅱ级切除11例,术后视力均有不同程度的恢复。术后2例并发少量皮下积液,2例出现一过性尿崩症,1例出现反复低钠低钾.均子对症处理恢复,均无嗅觉障碍发生。随访3-18个月均未见肿瘤复发.Karnofsky功能状态评分均≥80分。结论眉弓上锁孔入路手术完全适用于鞍区中大型脑膜瘤的治疗,具有美观,微创术后并发症少、恢复快等优点。

Objective To explore the clinical efficacy of removal of large and medium-sized meningiomas in the sellar region via neuroendoscope assisted supraorbital keyhole approach.Methods The clinical data of 13 patients with large and medium-sized m eningiomas in the sellar region acepted surgery via neuroendoscope assisted supraorbital keyhole approach in our hospital from March 2017 to March 2019 were analyzed retrospectively.The surgical efficacies of these patients were analyzed.Results Total removal was achieved in all 13 patients:2 were with Simpson I resection,and I1 with Simpson II resection.The vision was improved in all patients.After surgery,scalp hydrops appeared in 2 patients,transient diabetes insipidus in 2 patients,and recurrent hyponatremia and hypokalemia in one patient;these symptoms were relieved gradually for 2 wecks.No olfactory disturbance was noted in these 13 patients.Follow up for 3-18 months showed no recurrence,and Karmofsky performance status scores were>80.Conclusion Surgery via supraorbital key hole approach is suitable for large and medium sized meningiomas in the sellar region,with advantages of beauty,minimal invasion,few.postoperative complications and quick reco very.