论文部分内容阅读
本文总结了144例应用显微神经外科技术切除各种类型颅咽管瘤的结果,包括多种手术入路的评价。强调早期诊断的重要性。144例中135例(93.8%)行一次手术,8例行二次手术,1例行三次手术。130例经颅入路,14例经蝶窦入路。90%患者行肿瘤全切除手术,7%肿瘤复发。蝶窦入路:3例,这种入路最适用于鞍内隔下且肿瘤较小,特别是囊性变者。翼点入路:98例,另外还有30例与经胼胝体入路、14例与经蝶窦入路联合应用。此入路是视交叉周围肿瘤的目前最常用术式。可用于巨大肿瘤的切除。手术可通过视交叉周围间隙,如交叉前、视神经颈动脉或颈内动脉天幕三角,在颈动脉分叉的上方且通过终板的开口。皮层入路:2例,此2例肿瘤巨大,侵及大脑额叶
This article summarizes the results of 144 cases of various types of craniopharyngiomas removed by microsurgery using neurosurgery, including evaluation of multiple surgical approaches. Emphasizes the importance of early diagnosis. Among 144 cases, 135 cases (93.8%) had one operation, 8 cases had secondary surgery, and 1 case had three operations. 130 cases were transcranial and 14 cases were transsphenoidal. 90% of patients underwent total tumor resection and 7% of tumors relapsed. Sphenoid sinus approach: 3 cases, this approach is best used in the saddle and the tumor is smaller, especially cystic degeneration. Pterional approach: 98 cases, in addition to 30 cases with trans-corporal approach, 14 cases combined with transsphenoidal approach. This approach is currently the most common surgical technique for tumors around the optic chiasm. Can be used for the removal of huge tumors. Surgery can be done through the peri-optic space, such as before the cross, the optic nerve or carotid artery canopy triangle, above the carotid bifurcation and through the opening of the endplate. Cortical approach: 2 cases, 2 cases of massive tumor invasion of the frontal lobe