摘要
目的评估额纹切口经纵裂入路切除大型嗅沟脑膜瘤的安全性及治疗效果。方法回顾性分析18例经额纹切口纵裂入路治疗大型嗅沟脑膜瘤病人的临床资料。结果SimpsonⅡ级切除15例,Ⅲ级切除3例。术后病理:脑膜上皮型11例,非典型性6例,过渡型1例。WHO分级:Ⅰ级12例,Ⅱ级6例。术前嗅觉障碍14例;术后好转2例,无变化12例。术前视觉障碍11例,术后改善8例,无明显变化3例。术前癫疒间1例,术后症状消失。术前头晕头痛者,术后均明显好转。术后出现脑脊液鼻漏1例,脑水肿1例,无颅内感染、术区出血等并发症,无手术死亡病例。随访18例,时间3~96个月,术后3个月Karnofsky评分,恢复良好17例,轻微症状1例,无重度残疾及死亡病例。结论额纹切口经纵裂入路切除大型嗅沟脑膜瘤安全快捷,手术创伤小、并发症少。
Objective To evaluate the surgical safety and efficacy of large olfactory groove meningiomas resection via the frontal wrinkle incision and interhemispheric approach.Methods Clinical data of 18 patients with large olfactory groove meningiomas were analyzed retrospectively,who received surgery via the frontal wrinkle incision and interhemispheric approach.Results Simpson gradeⅡresection was achieved in 15 patients and Simpson gradeⅢresection in 3.The postoperative pathological results were meningothelial in 11 patients,atypital in 6 and transitional in 1.WHO classification were as follows:classⅠin 12 patients and classⅡin 6.Among the 14 patients with the olfactory disorder before surgery,the improvement was observed in 2 and no change in 12 after surgery.Among the 11 patients with visual disorder before surgery,the improvement was observed in 8 and no obvious change in 3.The seizure disappeared after surgery in 1 patient with preoperative epilepsy.The postoperative symptoms improved in all the patients with preoperative dizziness and headache.The cerebrospinal fluid leak occurred in 1 patient,brain edema in 1 after surgery.There were no intracranial infection,bleeding and death after surgery.All the patients were followed up for 3 to 96 months.The Karnofsky score 3 months after surgery showed that good recovery in 17 patients and mild symptoms in 1.No severe disability and death occurred.Conclusion The large olfactory groove meningiomas can be removed safely and quickly via the frontal wrinkle incision and interhemispheric approach which has less surgical trauma and fewer complications.
作者
高欣
王玉明
孙梅
黄楹
Gao Xin;Wang Yuming;Sun Mei;Huang Ying(Graduate School,Tianjin Medical University,Tianjin 300070,China;Department of Neurosurgery,Tianjin Huanhu Hospital,Tianjin 300060,China)
出处
《中国微侵袭神经外科杂志》
CAS
2020年第1期9-12,共4页
Chinese Journal of Minimally Invasive Neurosurgery
关键词
脑膜瘤
嗅沟
大型
入路
经纵裂
嗅觉障碍
视觉障碍
显微外科技术
meningioma,olfactory groove,large
approach,interhemispheric
olfactory disorder
visual disorder
microsurgery
作者简介
通讯作者:黄楹,Email:Yinghuang00@aliyun.com
