CAJ | 학술논문

目的探讨显微手术治疗鞍结节脑膜瘤伴视力障碍的手术入路选择、手术技巧及临床疗效.方法回顾性分析56例手术治疗的鞍结节脑膜瘤伴视力障碍患者的临床资料,22例采用冠切单侧额下入路,28例经额底外侧入路,6例经额颞入路.结果肿瘤切除程度按Simpson分级:Ⅰ级切除22例,Ⅱ级切除28例,Ⅳ级切除6例.术后视力改善47例,无明显变化7例,2例恶化.无手术死亡.结论术前根据肿瘤的大小、生长方式及与重要结构的毗邻关系选择合适的手术入路,同时娴熟的显微外科手术操作技巧是取得良好临床疗效的关键.
목적 탐토현미수술치료안결절뇌막류반시력장애적수술입로선택、수술기교급림상료효.방법 회고성분석56례수술치료적안결절뇌막류반시력장애환자적림상자료,22례채용관절단측액하입로,28례경액저외측입로,6례경액섭입로.결과 종류절제정도안Simpson분급:Ⅰ급절제22례,Ⅱ급절제28례,Ⅳ급절제6례.술후시력개선47례,무명현변화7례,2례악화.무수술사망.결론 술전근거종류적대소、생장방식급여중요결구적비린관계선택합괄적수술입로,동시한숙적현미외과수술조작기교시취득량호림상료효적관건.
Objective To explore the microsurgical approaches,operative techniques,and clinical results of tuberculum sellae meningiomas associated with visual impairment.Methods An retrospective analysis was made on 56 patients,with tuberculum sellae meningiomas associated with visual impairment,between Jan 2008 and Jan 2012.These patients underwent microsurgery through a variety of surgical approaches,such as the coronal craniotomy unilateral subfrontal approach (22 cases),the frontal-lateral approach (28 cases),and the frontal-temporal approach (6 cases).Results According to the Simpson classification after resection,there were 22 cases of Simpson Ⅰ,28 cases of Ⅱ,and 6 cases of Ⅳ.Visual impairment was improved in 47 cases,unchanged in 7,and worsened in 2.There was no case of death.Conclusions According to the size,location,growth pattern,and adjacent relationship to the important structures of these tumors,suitable surgical approaches should be selected for tuberculum sellae meningiomas before operation.The key point for good results is through the application of the skillful micro-neurosurgical technique.