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目的:总结前颅窝底巨大脑膜瘤的手术入路和切除方式,并分析特殊类型脑膜瘤的手术治疗方法。方法:回顾性分析2012至2014年间我科收治的21例前颅窝底巨大脑膜瘤病例的临床资料、手术经过及预后情况。结果:所有病例经影像学检查,并行显微手术治疗,肿瘤全切除(SimpsonⅠ、Ⅱ级切除)18例,近全切除3例,无死亡病例;除1例颅神经功能术前完全丧失外,术后神经功能改善者17例,无改善者2例,加重者1例。术后随访复查头颅MRI,肿瘤全切除组病例未见复发,近全切除有2例复发。结论:前颅窝底巨大脑膜瘤手术切除难度大,根据肿瘤部位选择正确手术入路,采用精细的显微外科技术,可取得良好的手术效果。
Objective: To summarize the surgical approach and resection of anterior giant cranial fossa meningiomas and to analyze the surgical treatment of specific types of meningiomas. Methods: A retrospective analysis of 21 cases of anterior cranial fossa meningioma admitted between 2012 and 2014 in our department was performed. The clinical data, the operation and the prognosis were retrospectively analyzed. Results: All the cases were treated with microsurgical operation and microsurgical treatment. All the tumors were resected (Simpson Ⅰ, Ⅱ level) in 18 cases, and nearly 3 cases were completely resected without any death. In addition to the complete loss of cranial nerve function in 1 case, There were 17 cases with postoperative neurological improvement, 2 cases without improvement and 1 case with aggravating. Follow-up review of head MRI, tumor resection group no recurrence, nearly 2 cases of total resection recurrence. Conclusion: Surgical resection of giant meningiomas in the anterior cranial fossa is very difficult. According to the selection of the correct surgical approach based on the tumor site, fine microsurgical techniques are used to obtain good surgical results.