[1]续岭,谢明国,孙飞吉,等.神经内镜经鼻蝶入路和经颅内镜眶上外侧入路切除鞍结节脑膜瘤[J].临床神经外科杂志,2020,17(03):268-272.[doi:DOI:10.3969/j.issn.1672-7770.2020.03.006]
 XU Lin,XIE Ming-guo,SUN Fei-ji,et al.Use of neuroendoscopy for removing tuberculum sellae meningiomas via endonasal transsphenoidal and lateral supraorbital approaches[J].Journal of Clinical Neurosurgery,2020,17(03):268-272.[doi:DOI:10.3969/j.issn.1672-7770.2020.03.006]
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神经内镜经鼻蝶入路和经颅内镜眶上外侧入路切除鞍结节脑膜瘤()
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《临床神经外科杂志》[ISSN:1672-7770/CN:32-1727/R]

卷:
17
期数:
2020年03期
页码:
268-272
栏目:
颅底肿瘤专题
出版日期:
2020-06-15

文章信息/Info

Title:
Use of neuroendoscopy for removing tuberculum sellae meningiomas via endonasal transsphenoidal and lateral supraorbital approaches
文章编号:
202003006
作者:
续岭谢明国孙飞吉杨朝志岳翔刘胜远倪勇廖鑫谢明祥王培肖顺武
563000 遵义,遵义医科大学附属医院神经外科(续岭,谢明国,孙飞吉,杨朝志,岳翔,刘胜远,谢明祥,王培,肖顺武);贵州医科大学第二附属医院神经外科(倪勇,廖鑫)
Author(s):
XU Lin XIE Ming-guo SUN Fei-ji et al.
Department of Neurosurgery, the Affiliated Hospital of Zunyi Medical University, Zunyi 563000, China
关键词:
神经内镜鞍结节脑膜瘤经鼻蝶入路眶上外侧入路
Keywords:
neuroendoscopy tuberculum sellae meningioma endonasal transsphenoidal approach lateral supraorbital approach
分类号:
R739.41
DOI:
DOI:10.3969/j.issn.1672-7770.2020.03.006
文献标志码:
A
摘要:
目的探讨神经内镜经鼻蝶入路和经颅内镜眶上外侧入路手术切除鞍结节脑膜瘤(TSM)的方法及效果。方法回顾性分析遵义医科大学附属医院神经外科2016年6月—2019年6月,14例行神经内镜手术切除鞍结节脑膜瘤患者的临床资料。其中经鼻蝶入路手术6例,经颅内镜眶上外侧入路8例。结果经鼻蝶入路组患者肿瘤切除均达到Simpson Ⅰ级,经眶上外侧入路组患者均达到Simpson Ⅱ级;除1例患者视力下降加重外,其余患者的视力障碍均较术前改善。术后2例患者出现嗅觉障碍,1例患者出现颅内感染;两组患者均无发生脑脊液漏。结论神经内镜经鼻蝶入路和经颅内镜眶上外侧入路均是手术切除鞍结节脑膜瘤的有效方法,两种内镜技术可全切除绝大部分的鞍结节脑膜瘤。经鼻内镜的优势是将复杂颅底脑膜瘤变为凸面脑膜瘤,对于质地较韧,且前交通动脉复合体包裹明显的血管保护有一定困难;经颅内镜可以无死角切除鞍结节脑膜瘤,对于侵犯视神经管的肿瘤的视神经减压有一定局限。两种技术可以优势互补,根据肿瘤的生长方式合理选择。
Abstract:
Objective To investigate the surgical experience of neuroendoscopic transsphenoidal approach and lateral supraorbital approach for the resection of tuberculum sellae meningiomas(TSM). Methods The clinical data of 14 patients with TSM performed neuroendoscopic resection, including 6 by endonasal transsphenoidal approach and 8 by lateral supraorbital approach at the Affiliated Hospital of Zunyi Medical University from June 2016 to June 2019,were analyzed retrospectively. Results The lesions in the endonasal transsphenoidal group were all removed to grade of Simpson Ⅰ, and the other lateral supraorbital group were grade of Simpson Ⅱ. The visual acuity of these two groups improved when compared to their preoperative status except one patient with worsen vision defect. Two patients experienced hyposmia, and one patient suffered from intracranial infection, and no cerebrospinal fluid leakage was found in these two groups. Conclusions Neuroendoscopic transsphenoidal approach and transcranial lateral supraorbital approach are effective surgical ways for the resection of TSM, and these two endoscopic techniques can completely remove most of the tumors.The neuroendoscopic transsphenoidal approach can transform complex skull base meningioma into convex meningioma,while it is difficult to protect the blood vessels with tough texture and obvious anterior communicating artery complex. The lateral supraorbital approach can resect tuberculum sellae meningioma without dead angle,while it has some limitations of optic nerve decompression for tumors invading optic canal. The two techniques can complement each other and be selected reasonably according to the growth mode of tumor.

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更新日期/Last Update: 2020-06-17