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目的总结眼眶内肿瘤和眶-颅沟通肿瘤经颅手术治疗方法和手术技巧。方法回顾分析经颅手术治疗的眼眶内肿瘤和眶-颅沟通肿瘤患者22例的临床表现、手术方法及疗效。其中,眼眶内肿瘤9例,眶-颅沟通肿瘤13例。均以翼点入路为基础,再根据具体情况扩大骨窗范围。结果病灶全切18例,次全切除3例,大部切除1例。术后动眼神经损伤4例,视力下降或失明4例,发热和脑脊液漏各1例。无手术死亡病例。随访4-48个月;除3例失访外,随访期内仅1例患者肿瘤复发二次手术。结论根据病灶的具体情况,采取相应的手术入路,严密保护视神经,实施经颅眼眶内肿瘤和眶-颅沟通肿瘤手术可以在最小创伤下,有效切除病灶。
Objective To summarize the methods and techniques of transcranial surgery for orbital-cranial tumors. Methods The clinical manifestations, surgical methods and curative effects of 22 cases of intraorbital tumors and orbital - cranial tumors were retrospectively analyzed. Among them, 9 were orbital tumors and 13 were orbital-cranial tumors. Pilots are based on the approach, according to the specific circumstances to expand the bone window range. Results The lesions were totally cut in 18 cases, subtotal resection in 3 cases and most resection in 1 case. Postoperative oculomotor nerve injury in 4 cases, decreased visual acuity or blindness in 4 cases, fever and cerebrospinal fluid leakage in 1 case. No surgical deaths. All cases were followed up for 4-48 months. Except for 3 cases lost to follow-up, only 1 patient underwent recurrence of the second surgery during the follow-up period. Conclusion According to the specific situation of the lesion, appropriate surgical approach is taken to protect the optic nerve closely. The operation of transcranial orbital tumor and orbital - cranial tumor operation can effectively remove the lesion under minimal trauma.