目的:探讨显微外科手术治疗鞍结节脑膜瘤的手术入路及技巧。方法回顾性分析32例鞍结节脑膜瘤的临床资料。其中,行单侧额下入路11例,翼点或扩大翼点入路11例,额外侧入路4例,眶上锁孔入路3例,经额底前纵裂入路3例。结果肿瘤全切除28例,其中Simpson Ⅰ级3例,Simpson Ⅱ级25例;肿瘤次全切除4例。术后视力改善11例,无明显变化10例,视力下降7例,4例昏迷者未做视力检查。结论术前早期诊断,选择合适手术入路及术中精细的显微外科操作是取得良好手术效果的保证。
Objective To summarize the experience of surgical treatment of 32 patients with tuberculum sellae meningiomas .Methods The data of 32 cases with tuberculum sellae meningiomas underwent microsurgical treatment were retrospectively analyzed .The operations were performed via unilateral subfrontal approach in 11 cases ,pterional approach in 11 cases ,frontolateral approach in 4 cases ,supra‐orbital keyhole approach in 3 cases ,and bi‐subffontal anterior longitudinal fission approach in 3 cases .Results The tumor was totally removed in 28 cases and subtotally removed in 4 cases .After surgery ,the eyesight was improved in 11 cases ,unchanged in 10 cases ,and worse in 3 cases .Conclusion The key points for better curative efficacy in the patients with tuberculum sellae meningiomas are early accurate diagnosis ,selection of proper operative approach and skillful microsurgical technique .