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目的:经蝶显微手术切除颅咽管瘤,适用起源于鞍底的肿物或向鞍上扩展者。作者回顾性总结了18例颅咽管瘤的诊断方式、手术技巧和治疗结果。方法:本组均经计算机体层摄影(CT)或磁共振成像(MRI)扫描确诊。手术采取经唇下—鼻中隔—蝶窦入路或经鼻前庭-鼻中隔—蝶窦入路两种方式行肿瘤切除术。结果:9例肿瘤获全切除,4例次全切除,其余5例为部分切除,无术后死亡。15例获长期随访(平均随访期为3年1个月),有12例(80％)恢复良好,3例影像学检查提示肿瘤复发,需行再次手术、放疗或放射外科治疗。结论:对颅咽管瘤选择合适病例经蝶入路显微手术切除,是一种安全、有效的方法。
Objective: Transcranial microsurgical removal of craniopharyngioma, for the origin of the saddle at the end of the tumor or expansion to the saddle. The authors retrospectively reviewed the diagnosis of 18 cases of craniopharyngiomas, surgical techniques and treatment results. Methods: The group was confirmed by computed tomography (CT) or magnetic resonance imaging (MRI). Surgical resection through the lip - nasal septum - sphenoid sinus approach or nasal vestibule - nasal septum - sphenoid sinus approach two ways of tumor resection. Results: Nine cases were totally resected, four cases were subtotally resected, and the remaining five cases were partially resected without any postoperative death. Fifteen patients were followed up for a long period of time (mean follow-up period was 3 years and 1 month). Twelve (80%) patients recovered well. Three cases of tumor recurrence were confirmed by radiological examination. Reoperation, radiotherapy and radiosurgery were required. Conclusion: It is a safe and effective method to select the appropriate cases for craniopharyngioma by microsurgical resection of transsphenoidal approach.