CAJ | 학술논문

目的探讨颅咽管瘤的手术入路选择.方法 32例颅咽管瘤,常规或扩大翼点入路14例,额下入路3例,额皮层切开经侧脑室-室间孔和额下联合入路5例,经胼胝体-穹窿间入路6例,胼胝体-穹窿间和额下联合入路2例,经额下-前纵裂联合入路2例.结果肿瘤全切26例,次全切4例,部分切除2例.结论根据肿瘤的不同分型选择合适的手术入路,是颅咽管瘤全切的关键.对于Samii分型Ⅰ、Ⅱ级应用额下和翼点入路;Ⅲ～Ⅴ级(无扩展)采用经胼胝体-透明隔间隙-穹窿间入路;Samii分型Ⅲ～Ⅴ级(有扩展)的肿瘤可通过胼胝体-透明隔-穹窿间入路联合额下入路、经额皮层造瘘-室间孔入路联合额下入路或经额下前纵裂联合入路均能达到全切除.
목적 탐토로인관류적수술입로선택.방법 32례로인관류,상규혹확대익점입로14례,액하입로3례,액피층절개경측뇌실-실간공화액하연합입로5례,경변지체-궁륭간입로6례,변지체-궁륭간화액하연합입로2례,경액하-전종렬연합입로2례.결과 종류전절26례,차전절4례,부분절제2례.결론 근거종류적불동분형선택합괄적수술입로,시로인관류전절적관건.대우Samii분형Ⅰ、Ⅱ급응용액하화익점입로;Ⅲ～Ⅴ급(무확전)채용경변지체-투명격간극-궁륭간입로;Samii분형Ⅲ～Ⅴ급(유확전)적종류가통과변지체-투명격-궁륭간입로연합액하입로、경액피층조루-실간공입로연합액하입로혹경액하전종렬연합입로균능체도전절제.
Objective To compare and evaluate several operative approaches for microsurgical treatment of craniopharyngiomas.Method Of 32 patients,14 cases were operated via pterional approach,3 via subfrontal approach,5 via transcortical-transforaminal approach combied with subfrontal approach,6 via transcallosal-interseptal-interforniceal approach,2 via transcallosal-interseptal-interforniceal approach combined with subfrontal approach,2 via transfrontal interhemispheric approach.Results Of 32 patients,total removal of tumor was achieved in 26 cases,4 subtotal removal,and 2 partical removal.Conclusions Selection of a suitable operative approach on the basis of different types of tumor is the key for total removal of craniopharyngioma.For Samii types,gradeⅠ～Ⅱcan be operated via subfrontal and pterional approach;grade Ⅲ～Ⅴ (without expansion) can be operated via transcallosal-interseptalinterforniceal approach;grade Ⅲ～Ⅴ(with expansion) can be removed by combined approaches,such as transcallosal- interseptal- interforniceal approach combined with subfrontal approach,transcorticaltransforaminal approach combied with subfrontal approach or transfrontal interhemispheric approach.