蝶骨嵴脑膜瘤的外科治疗

Surgical Treatment of Sphenoid Ridge Meningioma

目的 分析蝶骨嵴脑膜瘤的手术特点,提出术前评价及手术操作要点。方法 对180例蝶骨嵴脑膜瘤(内侧型116例,外侧型64例)患者的临床资料进行回顾性分析,此180例脑膜瘤均经额颞开颅显微手术治疗。结果 180例患者中,肿瘤全切134例(74.4％),近全切除35例(19.5％),大部切除11例(6.1％)。手术死亡5例(2.8％)。统计学分析表明,除肿瘤与血管粘连情况有明显差异外,上述二型肿瘤切除程度及术后严重并发症并无明显差异;而内侧型脑膜瘤因与血管、颅神经关系密切,术后易出现颅神经功能损伤。结论 根据肿瘤与蝶骨嵴的位置关系可将蝶骨嵴脑膜瘤分为内侧型和外侧型,头颅CT、MRI检查可明确诊断,治疗以显微手术切除肿瘤为主,对于未能全切除的蝶骨嵴脑膜瘤病人,术后可辅以放射治疗。

Objectives To analysis the surgical characteristics of sphenoid ridge meningioma (SRM) and to put forward its pre-operative valuation and operative key factors. Methods The clincal data of 180 patients with SRMs were analyzed retrospectively. The 180 case of SRMs divided into the lateral type (64) and the medial type (116) were removed by microneurosurgery through unilateral peterional approach. Results Of 180 cases of SRMs, 134 (74.4%) were totally resected, and 35 (19.5%) subtotally, and 11 (6.1%) in greater part. Five patietnts were postoperatively died (2.8%). Conclusions According to the site of the tumor, SRMs may be the midial and the lateral types. Diagnoses of the SRMs can defintely be made by CT scans and MRI. The SRMs are principally treated by microsurgical technique. The postoperative residual tumor should receive radiotherapy.