CAJ | 학술논문

目的探讨改良经颅眶上外侧壁入路治疗眶尖区肿瘤的手术指证、入路选择和显微外科手术策略.方法回顾性分析经颅开眶治疗的眶尖区肿瘤55例,采用改良经颅眶上外侧壁开眶入路,其中以眶-翼点为主39例,联合眶-额、眶-颧、颧-翼点入路16例.术后常规复查增强MRI,并进行密切随访.结果肿瘤全切除38例(69.1％),次全切除7例(12.7％),大部或部分切除7例(12.7％),活检3例(5.5％).术后视功能良好45例(81.8％),存在动眼神经和视神经损伤者9例(16.4％),偏瘫l例(1.8％).结论经颅眶上外侧壁开眶结合显微技巧可较好治疗眶尖区肿瘤；合适的角度开眶可最大限度切除眶尖区肿瘤和保护神经功能,减少不必要的创伤.
목적 탐토개량경로광상외측벽입로치료광첨구종류적수술지증、입로선택화현미외과수술책략.방법 회고성분석경로개광치료적광첨구종류55례,채용개량경로광상외측벽개광입로,기중이광-익점위주39례,연합광-액、광-권、권-익점입로16례.술후상규복사증강MRI,병진행밀절수방.결과 종류전절제38례(69.1％),차전절제7례(12.7％),대부혹부분절제7례(12.7％),활검3례(5.5％).술후시공능량호45례(81.8％),존재동안신경화시신경손상자9례(16.4％),편탄l례(1.8％).결론 경로광상외측벽개광결합현미기교가교호치료광첨구종류；합괄적각도개광가최대한도절제광첨구종류화보호신경공능,감소불필요적창상.
Objective To investigate the indications,approaches,and essentials of cranio-orbital surgeries for orbital tumors.Methods Fifty-five orbital tumors treated by refined transcranial orbitotomy through superolateral approaches,from 2003 to 2011,were reviewed.Thirty-nine tumors were excised with orbitopterional approaches,while 16 were excised with orbitofrontal approaches,orbitozygomatic approaches,or zygomatic-pterional approaches.Results Of the 55 orbital tumors,38 (69.1％) were totally resected,7 (12.7％) were subtotally resected,and 7 (12.7％) were partly resected.The other 3 (5.5％)took biopsies.The optic functions improved or retained in 45 (81.8％) patients.Nine (16.4％) patients suffered from eye-moving disfunctions or visual-acuity declines,and 1 (1.8％) patient suffered from hemiparalysis.Conclusions Tumors in the posterior and apex part of the orbit,or tumors extended from the orbit to the cranial,can be well treated through transcranial approaches.Appropriate methods may help to bring maximum convenience to exposure and excision of the lesions,and to conserve the functions.Unnecessary injuries could be avoided as well.