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鞍结节及鞍膈脑膜瘤——2.5年间20例手术的手术技巧及视力预后

Tuberculum and diaphragma sella meningioma--surgical technique and visual outcome in a series of 20 cases operated over a 2.5-year period.

作者信息

Margalit N, Kesler A, Ezer H, Freedman S, Ram Z

机构信息

Tel Aviv Medical Center, Department of Neurosurgery, Sackler School of Medicine, Tel-Aviv University, Tel Aviv, Israel.

出版信息

Acta Neurochir (Wien). 2007 Dec;149(12):1199-204; discussion 204. doi: 10.1007/s00701-007-1280-4. Epub 2007 Oct 29.

Abstract

BACKGROUND

A retrospective analysis of 20 cases of tuberculum sella meningioma with emphasis on the surgical technique and visual outcome.

METHODS

Between 2003 and 2006 twenty patients with tuberculum and diaphragma sella meningioma were treated at the Tel Aviv medical center. There were 17 females and 3 males. The age range was 28-83. Most patients presented with visual deterioration. Surgery was performed using the subfrontal approach. The visual function before and after surgery was evaluated as the main outcome parameter of the surgical treatment of these tumours.

FINDINGS

In 16 patients complete tumour resection was achieved and in 4 subtotal removal was performed. Visual acuity improved in 32% of the eyes and deterioration was observed in two eyes (5%). Visual field improved in 28% of the eyes and deteriorated in 14%. There was no complete vision loss as a result of surgery. There was no mortality in our series.

CONCLUSIONS

Tuberculum and diaphragma sella meningioma can be safely resected using the subfrontal approach with preservation and even improvement of visual function after surgery. Early surgery with better pre-operation visual function and smaller tumour size were associated with a better outcome.

摘要

背景

对20例鞍结节脑膜瘤进行回顾性分析,重点关注手术技巧和视力预后。

方法

2003年至2006年间,特拉维夫医疗中心对20例鞍结节及鞍膈脑膜瘤患者进行了治疗。其中女性17例,男性3例。年龄范围为28至83岁。大多数患者表现为视力下降。采用额下入路进行手术。将手术前后的视力功能作为这些肿瘤手术治疗的主要预后参数进行评估。

结果

16例患者实现了肿瘤全切,4例进行了次全切除。32%的患眼视力提高,2只眼(5%)视力下降。28%的患眼视野改善,14%的患眼视野恶化。手术未导致完全失明。本系列无死亡病例。

结论

采用额下入路可安全切除鞍结节及鞍膈脑膜瘤,术后视力功能可得到保留甚至改善。术前视力功能较好且肿瘤体积较小的患者早期手术,预后更佳。

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