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目的探讨超声刀显微神经外科治疗蝶骨嵴内1/3脑膜瘤手术技巧和治疗效果。方法对比分析1998～2005年间采用超声刀显微神经外科治疗39例蝶骨嵴内1/3脑膜瘤和1998年前应用传统显微外科手术治疗同一部位、同一类型肿瘤35例临床资料。结果本组39例中,肿瘤全切除32例,次全切除7例。术后颅高压症状消失16例,减轻6例；视力障碍缓解10例；面部麻木感减轻1例(病灶侧),眼睑下垂好转1例。术后CT随访半年至5年,肿瘤全切除32例中未见肿瘤复发,次全切除7例(1例死亡)中肿瘤复发1例。结论超声刀显微神经外科切除蝶骨嵴内1/3脑膜瘤是较为安全可靠的手术方法,肿瘤能否全切除关键取决于肿瘤与周围组织的粘连程度、大小及质地等情况。
Objective To investigate the surgical technique and therapeutic effect of ultrasonic knife microsurgical treatment of 1/3 meningioma in sphenoid ridge. Methods Thirty-nine cases of intraspinal sphenoid bone in 1/3 sphenoid bone meningiomas were treated with ultrasonic knife microsurgery between 1998 and 2005 and 35 cases of the same type and same type of tumor treated with traditional microsurgery before 1998. Results In this group of 39 cases, 32 cases were completely resected and 7 cases were subtotally resected. Postoperative symptoms of intracranial hypertension disappeared in 16 cases, 6 cases were alleviated; 10 cases of visual impairment were relieved; facial numbness was alleviated in 1 case (lesion side) and eyelid ptosis was improved in 1 case. Postoperative CT was followed up for 6 months to 5 years. No tumor recurrence was found in 32 cases of complete resection of the tumor, and 1 case of tumor recurrence in 7 cases (1 case died) of subtotal resection. Conclusions Ultrasound knife microsurgical neurosurgery resection of 1/3 meningioma in the sphenoid ridge is a safe and reliable surgical method. Whether or not the tumor is fully resected depends on the degree of adhesion, size and texture of the tumor and the surrounding tissue.