鞍区胆脂瘤的诊断及治疗

Diagnosis and treatment of cholesteatoma in sellar region

目的探讨鞍区胆脂瘤的诊断及显微手术全切除的入路和方法。方法总结19例经显微手术切除的鞍区胆脂瘤病人的临床资料。视力下降16例,头痛18例,癫4例,多饮、多尿14例,三叉神经痛4例。CT均为低密度病灶;10例行MRI检查,示鞍上池占位病变,T1W低信号,T2W高信号。5例经额下入路,14例经翼点入路切除。结果全切除16例,3例次全切除,内分泌、癫及三叉神经痛症状均消失,视力均有不同程度改善。结论鞍区胆脂瘤显微手术全切除效果理想,翼点入路是最佳入路。

Objective To explored the method and approach of diagnosis and treatment of cholesteatoma in sellar region. Methods 19 patients were treated by microsurgical resection, in whom 16 patients with diminished visual acuity, 18 patients with headache, 4 patients with epilepsy, 14 patients with polydipsia and polyurine, 4 patients with trigminal neuralgia. All patients showed lesion of low density on CT scan, 10 patients received MRI examination which revealed the suprasellar mass with low signal on T1W and high signal on T2W. 14 patients were operated via the right pterional approach, 4 patients via transsubfrontal approach. Results Total removal was achieved in 16 cases, and subtotal removal in 3. All patients were followed up for 2 months to 5 years, and recovered to normal life and study ,the symptoms of endocrine?epilepsy and trifacial neuralgia extincted. Conclusion It is ideal to totally remove the cholesteatoma of sellar region by microsurgery, and the right pterional approach is the best approach.