显微手术治疗前颅底脑膜瘤(附25例报告)-东南大学学报医学版

显微手术治疗前颅底脑膜瘤(附25例报告)

单位：安庆市第一人民医院神经外科, 安徽安庆 246004

分类号：R739.45;R730.56

出版年·卷·期（页码）：2015·34·第四期（557-561）

摘要：

目的:提高前颅底脑膜瘤显微手术的水平和成功率。方法:回顾分析2002年2月至2014年1月利用显微外科技术治疗的18例嗅沟脑膜瘤、6例鞍结节脑膜瘤及1例嗅沟脑膜瘤合并鞍结节脑膜瘤的临床资料。结果:18例嗅沟脑膜瘤中17例全切,1例次全切除。6例鞍结节脑膜瘤中4例全切,2例次全切除。1例嗅沟脑膜瘤合并鞍结节脑膜瘤肿瘤全切。手术并发症有嗅觉丧失、癫痫发作、一过性尿崩、视野缺损等,经适当处理恢复良好。结论:CT、MRI诊断前颅底脑膜瘤可靠,有助于手术入路选择和暴露满意;尽量切除附着部位肿瘤阻断肿瘤供血,显微镜和超声吸引装置有肯定的辅助作用。

Objective: To improve the microsurgical skills and success rates of anterior cranial fossa meningiomas. Methods: A retrospective analysis was carried out on 25 patients who underwent microsurgery between February 2002 and January 2014. Among them, there were 18 cases of olfactory groove meningiomas, 6 cases of tuberculum sellae meningiomas and 1 case of olfactory groove meningioma combined with tuberculum sellae meningioma. Results: Eighteen cases of olfactory groove meningiomas excision were achieved in seventeen cases, while subtotal excision was performed in one case. Six cases of tuberculum sellae meningiomas excision were achieved in four cases, while subtotal excision was performed in two cases. One case of olfactory groove meningioma combined with sellae meningioma was performed by total resection. The complications related to operation included: loss of sense of smell, seizures, diabetes insipidus, visual field defect, et al. After appropriate treatments, all patients obtained good recovery. Conclusion: CT and MRI are reliable to diagnose anterior cranial fossa meningiomas and helpful to the operation approach and satisfactory exposure. Microscope and cavitron ultrasonic surgical aspirator have auxiliary effect for sure in the attachment site of tumor resection, and blocking the blood supply of tumor.

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