颅底脑膜瘤的显微手术治疗

目的：总结颅底脑膜瘤的显微手术治疗经验．方法回顾分析显微镜直视下手术切除10例颅底脑膜瘤的临床资料,其中嗅沟脑膜瘤3例,蝶骨嵴脑膜瘤、中颅窝底脑膜瘤、桥小脑角脑膜瘤各2例,颞叶天摹脑膜瘤1例．结果肿瘤全切除7例,次全切除3例．无严重并发症或死亡病例．术后2个月全部病人症状改善．9例获随访、2a脑膜瘤复发1例．结论选择好手术入路和运用好显微外科技术可以提高颅底脑膜瘤的全切率,降低死亡率．     

显微手术切除颅底肿瘤178例

目的 探讨在显微手术条件下切除颅底肿瘤的手术入路.方法 总结178例颅底肿瘤的经验,讨论颅底不同部位手术入路特点,最大程度地切除肿瘤,尽量保护颅底、颅内重要结构,减少并发症.结果 前颅窝底肿瘤13例,全切13例;中颅窝底肿瘤107例,全切63例,次全切37例,死亡7例;后颅窝肿瘤58例,全切40例,次全切15例.结论 最佳手术入路的选择应相对于不同颅底部位的肿瘤,针对特殊的解剖结构而选择.合适的入路对手术的成功至关重要.     

经眉弓锁孔入路手术治疗鞍区附近及前颅窝底病变35例临床分析

目的 总结经眉弓锁孔入路治疗鞍区附近及前颅窝底病变的手术经验.方法 回顾性分析近3年来收治的35例鞍区附近及前颅窝底病变的经眉弓锁孔手术经验.其中,垂体瘤12例,鞍结节脑膜瘤1例,颅咽管瘤2例,嗅沟脑膜瘤2例,前交通动脉瘤18例.均行经眉弓锁孔入路手术治疗.结果 17例肿瘤病变全切除15例,18例动脉瘤均行夹闭.1例前...     

颧颞入路切除中颅底肿瘤

目的 探讨颧颞入路对中颅底肿瘤的疗效。方法 对中颅窝脑膜瘤 ,颅咽管癌、离膜肉瘤及神经鞘瘤各１例,采用颧颞入路手术,取下颧弓以扩大中颅窝底视野,对肿瘤长入后颅窝者,切开小脑天幕,切除天幕下肿瘤,对向前颅底及眶内生长者,以扩大的颧颞眶入路手术。结果 中颅底肿瘤全切６例,次全切３例,大部切除３例,肿瘤残留与肿瘤侵犯海绵窦、包绕颈内动脉、脑干受浸润有关。结论 颧颞入路可有效地适用于中颅底肿瘤切除术。     

颧颞入路切除中颅底肿瘤

目的　探讨颧颞入路对中颅底肿瘤的疗效。方法　对中颅窝脑膜瘤 9例 ,颅咽管瘤、脑膜肉瘤及神经鞘瘤各 1例 ,采用颧颞入路手术 ,取下颧弓以扩大中颅窝底视野。对肿瘤长入后颅窝者 ,切开小脑天幕 ,切除天幕下肿瘤 ,对向前颅底及眶内生长者 ,以扩大的颧颞眶入路手术。结果　中颅底肿瘤全切 6例 ,次全切 3例 ,大部切除 3例。肿瘤残留与肿瘤侵犯海绵窦、包绕颈内动脉、脑干受浸润有关。结论　颧颞入路可有效地适用于中颅底肿瘤切除术。     

前颅底大型脑膜瘤的显微手术治疗

目的探讨前颅底大型脑膜瘤的手术入路、显微手术方法和治疗效果。方法对显微手术治疗的21例前颅底大型脑膜瘤患者的影像学资料、手术入路、显微手术切除肿瘤的方法及疗效进行回顾性分析。结果按照Simpson切除标准,本组21例中,Ⅰ级切除16例(76.19%);Ⅱ级切除3例(14.29%);Ⅳ级切除2例即行脑膜瘤次全切除(9.52%)。肿瘤全切除90.48%,次全切除9.52%。无手术死亡,随访6~24个月,无复发。结论充分的术前影像学检查及评估,采用显微手术切除前颅底大型脑膜瘤,术中保护重要神经与血管、处理好受累的颅底骨质和脑膜,能明显提高肿瘤的全切除率,减少并发症,提高临床疗效。     

中颅底肿瘤的显微外科治疗

目的：介绍了采用手术新入路,以显微外科技术切除累及中颅窝及鞍上,鞍旁肿瘤10例的体会,方法：采用眶－翼点及眶－颧弓入路经中颅窝硬膜外等改良翼点新的手术入路,同时采用显微外科技术切除中颅底肿瘤。结果：新的手术入中扩大了肿瘤的暴露范围,有利于肿瘤的切除,本组全切除7例,次全切除2例,大部切除1例,9例恢复良好,死亡1例,结论：采用眶－翼点及眶－颧弓入路经中颅窝硬膜外等改良翼点新的手术入路,结合显微外科技术是切除中颅底肿瘤的有效方法,可提高手术切除率,减少手术并发症,降低手术死亡率。     

颅底脑膜瘤的诊断及治疗(附46例报告)

目的：介绍４６例颅底脑膜瘤的诊断和治疗。方法：分析４６例颅底脑膜瘤的临床及影像学特征、手术方法、手术结果、术后并发症等。结果：颅底脑膜瘤全切除３７例,次全切除９例,其中１２例采用显微手术,疗效优于直视手术,术后死亡２例。５例术后颅神经症状加重,２１例无任何神经损伤症状,２０例颅神经症状同术前。结论：颅底脑膜瘤的手术治疗,熟悉颅底解剖选择良好入路可提高疗效,利用显微技术可提高全切除率,降低术后并发症和颅神经损伤率     

颅脑脑膜瘤的诊断及治疗（附46例报告）

目的 介绍４６例颅底脑膜瘤的诊断和治疗,方法 分析４６例颅底脑膜瘤的临床及影像学特征,手术方法,手术结果,术后并发症等。结果 颅底脑膜瘤全切除３７例,次全切除９例,其中１２例采用显微手术,疗效优于直视手术,术后死亡２例,５例术后颅神经症状加重,２１例无任何神经损伤症状２０例颅神经症状同术前,结论 颅底脑膜瘤的手术治疗,熟悉颅底解剖选择良好入路可提高疗效,利用显微技术可提高全切除率,降低术后并发症和     

嗅沟脑膜瘤的显微外科手术治疗(附21例临床分析)

目的探讨嗅沟脑膜瘤显微外科手术治疗的临床疗效。方法回顾性分析显微手术治疗嗅沟脑膜瘤21例的临床治疗情况和随访资料,对嗅沟脑膜瘤的显微手术技巧和颅底重建方法进行探讨。结果 21例脑膜瘤显微手术,Simpson I级全切除19例(90.5%),SimpsonⅡ级全切除2例(9.5%)。术前视力变差的15例,术后视力改善14例,术后视力无改善1例;Simpson I级全切除的病例术后平均随访30个月未见肿瘤复发。结论应用显微外科手术全切除嗅沟脑膜瘤和严密的颅底重建,能够取得较好的临床疗效。     

自体颅骨瓣帽状腱膜下保存与再植67例临床分析

目的:探讨颅高压病人去骨瓣减压,骨瓣保存于邻近骨窗的帽状腱膜下,对其进行保存和再植的临床效果。方法:对67例颅高压病人行去骨瓣减压术,将骨瓣保存于帽状腱膜下,待高颅压缓解,将颅骨瓣再植。结果:帽状腱膜下保存的颅骨瓣新鲜、无吸收改变,病理学检查骨细胞存活。随访6月至3年,行X线片、CT等检查显示颅骨瓣存活,骨性愈合。结论:帽状腱膜下自体颅骨保存与再植是修补颅骨最有效方法之一。     

胎儿颅骨骨膜修补颅骨缺损的临床应用

目的：评价异体胎儿颅骨骨膜修补颅骨缺损的临床效果。方法：应用异体胎儿颅骨骨膜移植修补１２例颅骨员,定期摄头颅Ｘ线片检查成骨情况,４例半年穿刺活检。结果：１年内骨生长７例,３年内全部成骨。无排斥反应。结论：胎儿颅骨膜移植成骨可靠,但早期塑形欠佳。     

The skull in chronic sarcoidosis

A report of a 63 year old woman with giant osteolytic skull lesions simulating metastatic disease, and generalized cutaneous lesions is presented. Biopsy of a skin lesion revealed non-caseating granulomas compatible with sarcoidosis. The literature dealing with calvarial sarcoidosis is reviewed.     

Tumors of the skull base

Recognition of the many benign and malignant tumors that occur in the skull base is now simple, given three-dimensional CT scanning and MRI with enhancement. Recent developments in surgical technique have allowed these tumors to be approached, but only in the past two to three years has radical surgery been possible.     

Fibrous dysplasia on the skull

A young rickshaw puller admitted in Neurosurgery ward of Mymensingh Medical College Hospital due to ugly looking skull swelling on right side and iatrogenic ulceration on the postero-superior surface of the swelling. He also mentioned that he was not socially well-excepted and facing difficulty in getting married for that ugly lesion and was very unhappy at that time. CT scan was suggestive of fibrous dysplasia of skull bone and no other abnormalities were present on other part of the body. Then complete excision of the mass was done and fibrous dysplasia was confirmed by histopathological study. Two months after surgery he got married and expressed his happiness. In fibrous dysplasia, normal bone is replaced by fibrous connective tissue with varying degrees of osseous metaplasia. It is a benign disorder of bone commonly seen from childhood to the third decade. Virtually any bone in the body can be affected. Regarding investigations, plain radiography in the first line study. CT may be required to assess complex region such as the spine, pelvis, chest and facial skeleton. Histologically, fibrous dysplasia appears as multiple areas of fibrous tissue contained within islands of bone with evidence of both blastic and clastic activity.     

Median defect in the skull

A median defect in the region of the root of the nose, in between the two orbits, was discovered in the dried skull of a 44-year-old female cadaver, during routine undergraduate teaching. The two small nasal bones articulated with each other and the cribriform plate of the ethmoid. The lacrimal bones and frontal processes of the maxillary bones were also deformed. We propose that the median defect was due to abnormality at the fonticulus frontalis, the prenasal space and the interorbitonasal part of the nasal capsule, as well as defects in the ossification of the maxilla, lacrimal and frontal bones.     

Congenital depression of neonatal skull

Congenital neonatal skull depression, not associated with trauma is a rare clinical entity, with an incidence of 1 in 10000. The depression is thought to be due to compression by foetal limbs or maternal pelvis. Though the condition is mostly self-resolving over the course of a few months, it causes tremendous parental anxiety. We report a case of non-traumatic, congenital depression of skull of a neonate at birth without any neurological deficit or intracranial abnormality noticed on imaging.