[1]赵亚超方军超杨晋生范波.经眶入路神经内镜手术治疗颅中窝底病变的疗效分析(附17例报道)[J].中国临床神经外科杂志,2022,27(02):75-77.[doi:10.13798/j.issn.1009-153X.2022.02.004]
 ZHAO Ya-chao,FANG Jun-chao,YANG Jin-sheng,et al.Surgery through endoscopic transorbital approach for patients with middle cranial fossa lesion: report of 17 cases[J].,2022,27(02):75-77.[doi:10.13798/j.issn.1009-153X.2022.02.004]
点击复制

经眶入路神经内镜手术治疗颅中窝底病变的疗效分析(附17例报道)()
分享到:

《中国临床神经外科杂志》[ISSN:1009-153X/CN:42-1603/TN]

卷:
27
期数:
2022年02期
页码:
75-77
栏目:
论著
出版日期:
2022-02-25

文章信息/Info

Title:
Surgery through endoscopic transorbital approach for patients with middle cranial fossa lesion: report of 17 cases
文章编号:
1009-153X(2022)02-0075-03
作者:
赵亚超方军超杨晋生范波
471003 河南洛阳,河南科技大学第一附属医院神经外科(赵亚超、方军超、杨晋生、范波)
Author(s):
ZHAO Ya-chao FANG Jun-chao YANG Jin-sheng FAN Bo.
Department of Neurosurgery, The First Affiliated Hospital of Henan University of Science and Technology, Luoyang 471003, China
关键词:
颅内肿瘤颅中窝底病变神经内镜手术经眶入路疗效
Keywords:
Intracranial tumor Middle cranial fossa lesions Endoscopic transorbital approach Surgery Clinical efficacy
分类号:
R 739.41; R 651.1+1
DOI:
10.13798/j.issn.1009-153X.2022.02.004
文献标志码:
A
摘要:
目的 探讨神经内镜下经眶入路(ETOA)手术治疗颅中窝底肿瘤的疗效。方法回顾性分析2017年6月至2021年3月ETOA手术治疗的17例颅中窝底病变的临床资料。结果术后病理显示脑膜瘤9例,胶质瘤3例,神经鞘瘤2例,淋巴瘤1例,海绵状血管瘤1例,血管外皮细胞瘤1例。肿瘤全切除11例,次全切除5例,部分切除1例。术后出现脑脊液漏2例、短暂性动眼神经麻痹3例、脑梗死1例、颅内大出血1例(再次手术)。出院后随访6~24个月,无死亡病例;1例次全切除胶质瘤术后12个月出现进展,二次手术;其余病例未见复发或进展。术后6个月,改良Rankin量表评分0~2分14例,3分3例。结论ETOA手术是治疗颅中窝底病变的有效方法,可达到令人满意的切除程度,并有效地减少并发症。
Abstract:
Objective To explore the clinical efficacy of surgery through endoscopic transorbital approach (ETOA) for the patients with middle cranial fossa lesion. Methods The clinical data of 17 patients with middle cranial fossa lesion who underwent surgery through ETOA from June 2017 to March 2021 were analyzed retrospectively. Results The postoperative pathological examination showed meningiomas in 9 patients, gliomas in 3, schwannomas in 2, lymphoma in 1, cavernous hemangioma in 1 and hemangiopericytoma in 1. Total resection of the tumor was achieved in 11 patients, subtotal in 5 and partial in 1. After the operation, cerebrospinal fluid leakage occurred in 2 patients, transient oculomotor nerve palsy occurred in 3, cerebral infarction occurred in 1, and heavery intracranial hemorrhage (reoperation) occurred in 1. The follow-up (range, 6~24 months) showed tumor progression in 1 glioma patient who received subtotal resection 12 months after the operation, and no recurrence or progression in the other 16 patients. The modified Rankin scale score of 0~2 was achieved in 14 patients and score of 3 in 3 patients 6 months after the operation. Conclusions Surgery through ETOA is an effective treatment for the middle cranial fossa lesions, which can achieve a satisfactory degree of lesion resection and effectively reduce the postoperative complications.

参考文献/References:

[1] 首都医科大学眼部肿瘤临床诊疗与研究中心,中华医学 会放射学分会头颈学组. 眼眶肿瘤和肿瘤样病变3.0 T MR检查与诊断专家共识[J]. 中华放射学杂志,2021,55 (10):1008-1023.
[2] Di Somma A, Andaluz N, Cavallo LM, et al. Endoscopic transorbital superior eyelid approach: anatomical study from a neurosurgical perspective [J]. J Neurosurg, 2018, 129 (5): 1203-1216.
[3] Jeon C, Hong CK, Woo KI, et al. Endoscopic transorbital surgery forMeckel’s cave and middle cranial fossa tumors: surgical technique and early results [J]. J Neurosurg, 2018, 131(4): 1126-1135.
[4] Lee MH, Hong SD, Woo KI, et al. Endoscopic endonasal versus transorbital surgery for middle cranial fossa tumors: comparison of clinical outcomes based on surgical corridors [J]. World Neurosurg, 2019, 122: e1491-e1504.
[5] 马越,黄振华,何京川. 内镜下经眶入路的解剖学和临 床应用进展[J]. 中国现代神经疾病杂志,2020,20(8): 752-756.
[6] Brokinkel B, Spille DC, Brokinkel C, et al. The Simpson grading: defining the optimal threshold for gross total resection in meningioma surgery [J]. Neurosurg Rev, 2021, 44(3): 1713-1720.
[7] Landriel Ibanez FA, Hem S, Ajler P, et al. A new classification of complications in neurosurgery [J]. World Neurosurg, 2011, 75(5-6): 709-715.
[8] Alves-Belo JT, Mangussi-Gomes J, Truong HQ, et al. Lateral transorbital versus endonasal transpterygoid approach to the lateral recess of the sphenoid sinus-a comparative anatomic study [J]. Oper Neurosurg (Hagerstown), 2019, 16 (5): 600-606.
[9] Almeida JP, Omay SB, Shetty SR, et al. Transorbital endoscopic eyelid approach for resection of sphenoorbital meningiomas with predominant hyperostosis: report of 2 cases [J]. J Neurosurg, 2018, 128(6): 1885-1895.
[10] 陶鹏,隋建美,徐源,等. 经眶颧入路切除蝶骨嵴内侧 及前颅窝颅眶沟通巨大脑膜瘤1例[J]. 贵州医药,2018, 42(8):1002-1004.

相似文献/References:

[1]葛怡宁 幸 兵 姚 勇 邓 侃 王任直.颅咽管瘤合并毛细胞星形细胞瘤1例[J].中国临床神经外科杂志,2016,(05):319.[doi:10.13798/j.issn.1009-153X.2016.05.023]
[2]赵子进 综述 袁贤瑞 刘 庆 审校.岩斜区肿瘤分型与手术入路选择[J].中国临床神经外科杂志,2016,(01):60.[doi:10.13798/j.issn.1009-153X.2016.01.023]
[3]李 响 Raynald 朱婉春 宫 剑.小儿颅内胚胎癌1例[J].中国临床神经外科杂志,2016,(01):63.[doi:10.13798/j.issn.1009-153X.2016.01.024]
[4]王在贵 张新元 吕丽辉 杨 铭 徐国政 马廉亭 刘 征 杨 柳 李国栋 伍 杰.胶质瘤术后大脑前动脉假性动脉瘤形成的诊治(附1例报告并文献复习)[J].中国临床神经外科杂志,2015,(10):600.[doi:10.13798/j.issn.1009-153X.2015.10.008]
 ANG Zai-gui,ZHANG Xin-yuan,Lü Li-hui,et al.Diagnosis and treatment of postoperative pseudoaneurysm of anterior cerebral artery in patient with glioma (case report and review of literature)[J].,2015,(02):600.[doi:10.13798/j.issn.1009-153X.2015.10.008]
[5]王林风.颅内孤立性纤维性肿瘤1例[J].中国临床神经外科杂志,2015,(08):462.[doi:10.13798/j.issn.1009-153X.2015.08.005]
[6]甘 武 詹升全 郭文龙 林晓风 周 东 唐 凯 周德祥.额外侧入路手术切除前颅窝底及鞍区肿瘤[J].中国临床神经外科杂志,2016,(10):583.[doi:10.13798/j.issn.1009-153X.2016.10.003]
 GAN Wu,ZHAN Sheng-quan,GUO Wen-long,et al.Microsurgery via the frontolateral approach for the anterior cranial fossa and sellar region tumors[J].,2016,(02):583.[doi:10.13798/j.issn.1009-153X.2016.10.003]
[7]郭一新 陆业平.颅内肿瘤切除术后帕瑞昔布钠的镇痛效果[J].中国临床神经外科杂志,2016,(10):640.[doi:10.13798/j.issn.1009-153X.2016.10.028]
[8]关海滨 黄燕萍 魏晓丹 蔡 霞 朱鑫华 宁玉萍 宋 懿.早期应用ACTS预防颅内肿瘤术后下肢深静脉血栓形成[J].中国临床神经外科杂志,2017,(01):38.[doi:10.13798/j.issn.1009-153X.2017.01.014]
[9]张道宝,朱晓丹,万晓强,等.神经内镜辅助技术在显微手术切除桥小脑角区肿瘤中的应用[J].中国临床神经外科杂志,2017,(02):103.[doi:10.13798/j.issn.1009-153X.2017.02.015]
[10]邓晓松.成人小脑肿瘤术后并发小脑性缄默1例[J].中国临床神经外科杂志,2017,(03):203.[doi:10.13798/j.issn.1009-153X.2017.03.030]

备注/Memo

备注/Memo:
通讯作者:范波,E-mail:lilirong999@sina.com
更新日期/Last Update: 1900-01-01