儿童颅眶沟通肿瘤的诊断治疗附16例临床分析.pdfVIP

232 《中国神经肿瘤杂志》2007，5(4)：232—234 · 专题· 儿童颅眶沟通肿瘤的诊断治疗附16例临床分析 裴 杰 (青海大学附属医院神经外科，青海 西宁 810001) 【摘要】背景与目的：一般前中颅窝底肿瘤在目前的手术技术和设备条件下切除并不困难．但侵及颅眶并 沟通的肿瘤人路困难，全切除率低，手术难度较大，仍是神经外科医生棘手难题。本文讨论了儿童颅眶沟通肿 瘤的生长特点、诊断，具体手术人路，治疗方法与预后。方法：16例患儿根据肿瘤生长部位及侵及范围不同而 分别采用了翼点眶外侧壁人路、改良翼点额底硬膜外眶顶人路二种手术方式．前一种手术人路7例．后一种手 术人路9例。原则上一般先切除颅内肿瘤再开眶切除眶内肿瘤。结果：全切除 10例，次全切除6例。术后病理 证实脑膜瘤6例，视神经纤维瘤6例、海绵状血管瘤2例，脊索瘤2例。术后患儿眼球突出均有不同程度改善． 眼球活动障碍4例，术后视力好转 10例，上睑下垂3例．术前已失明2例及4例视力仅为光感患儿无恢复。结 论：手术治疗是儿童颅眶沟通肿瘤这类疾病唯一有效的治疗方法。既便是单眼失明不能恢复也仍可保住患儿 生命及眼睛外形，术后残余肿瘤行放疗可减少复发。 关键词：儿童颅眶沟通肿瘤；手术人路；诊断；治疗 中图分类号：R739．41 文献标识码：A 文章编号：1726—8192(2007)04—0232—03 Diagnosis and Treatment of Cranio-orbital Tumors in Children：Analysis of 16 Cases Jie Pei Department of Neurosurgery，Qinghai University Affiliated Hospital，Xining 810001，尸．R．China 【ABSTRACT】BACKGROUNDOBJECTIVE：Generally，tumors in anterior and middle skull base can be totally resected using current operation techniques and equipment． However， when the tumors involve both intracranial and orbit， total removal of these tumors are more difiqcult． In this article， we discussed the characterization，diagnosis，neurosurgical approaches，surgical techniques and the prognosis of cranio—orbital tumors in children． METHOD： Among 16 child patients， 7 cases were treated via pterional approach and 9 cases via modified pterional extradural approach， according to the localization and invasion style of the tumors．In principle， intracranial tumors were resected first and then the residues involving the orbital area．RESULT：Among 1 6 cases， total removal was achieved in 1 0 cases and subtotal removal in 6 cases． Confirmed by