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目的探讨眼眶神经鞘瘤的临床诊断和手术治疗方法。方法对1999年8月至2003年12月在北京武警总医院眼眶病研究所治疗的38例眼眶神经鞘瘤患者进行回顾性分析。结果38例中男性15例,女性23例,年龄9-65岁,平均22岁。其中行标准化A／B超检查者37例,CT扫描38例,MRI成像33例。手术入路的选择有外侧开眶(包括改良外侧开眶)26例,内外联合开眶2例,前路开眶4例,内侧开眶2例。其中肿瘤囊内切除21例,肿瘤整体切除15例,部分切除联合术后放射治疗2例。随访时间平均为23个月,手术并发症包括视力丧失1例,上睑下垂2例,眼球运动障碍2例。结论现代影像学检查方法尤其是MRI对眼眶神经鞘瘤的术前定性、定位诊断及对手术入路的选择提供可靠依据,熟练的手术方法和技巧可提高治愈率,减少手术并发症。
Objective To investigate the clinical diagnosis and surgical treatment of orbital schwannoma. Methods A retrospective analysis was performed on 38 patients with orbital nerve sheath tumors treated by the Orbital Disease Research Institute of Beijing Armed Police General Hospital from August 1999 to December 2003. Results 38 cases of male 15 cases, 23 females, aged 9-65 years, mean 22 years. Among them, 37 were normalized A / B ultrasonographers, 38 were CT scans, and 33 were MRI scans. The choice of surgical approach with lateral orbital (including the improvement of lateral orbital) in 26 cases, combined with internal and external open orbit in 2 cases, 4 cases of anterior open orbit, medial orbit 2 cases. Among them, 21 cases were resected in the cyst, 15 cases were resected in the whole tumor, and 2 cases were partially resected combined with postoperative radiotherapy. The average follow-up time was 23 months. The complications included 1 case of loss of vision, 2 cases of ptosis and 2 cases of eye movement disorder. Conclusions Modern imaging examination methods, especially MRI, provide preoperative confirmation of the orbital schwannoma preoperatively, location diagnosis and choice of surgical approaches. Skilled surgical methods and techniques can improve the cure rate and reduce the complications of surgery.