前颅底、蝶骨嵴大型脑膜瘤的显微手术治疗

目的:总结前颅底、蝶骨嵴大型脑膜瘤显微手术治疗经验。方法:对21例前颅底、蝶骨嵴大型脑膜瘤患者的影像学资料、手术入路、显微手术切除的方法及疗效进行分析。结果:按照Simpson切除标准,本组21例中Ⅰ级切除14例,Ⅱ级切除2例,Ⅲ级切除1例,Ⅳ级切除4例;术后复发1例再次手术切除;术中无死亡或出现凶险大出血病例。结论:肿瘤全切除是预防复发的有效措施,充分的术前影像学检查及评估,术中保护重要神经与血管,能明显提高肿瘤的全切除率,减少并发症。

Microsurgical treatment of large meningiomas at anterior skull base and sphenoid ridge

Objective To summarize the experience of the operation of large meningiomas at anterior skull base and sphenoid ridge. Methods Clinical data including imaging data, the operative approach, microsurgery methods and curative effect were analyzed in 21 cases of large meningiomas at anterior skull base and sphenoid ridge. Results According to Simpson's resection degree, 14 cases received Grade Ⅰ resection, 2 received Grade Ⅱ resection, 1 received Grade Ⅲ resection, and 4 received Grade Ⅳ resection. Of the 4 cases, 1 recurrent case was performed resection again. No death or dangerous hemorrhage occurred in the operation. Conclusion Whole-resection of meningiomas at anterior skull base and sphenoid ridge is an effective measure to prevent recurrence. The measurements including sufficient preoperative imaging evaluation, good protection of the nerve and blood vessel during the operations can significantly increase the percentage of total removal of large meningiomas at anterior skull base and sphenoid ridge, and decrease postoperative complications.