Department of Neurosurgery, Beijng Tiantan Hospital, Capital Medical University, Beijing, China.
Chin Med J (Engl). 2009 Aug 20;122(16):1857-61.
There are few reports of microsurgical treatment of dorsum sellae meningiomas-which, because of location, size, and differences in growth direction, clinical presentations, degree of surgical difficulty, have varied posttreatment sequelae. In pursuit of an optimal microsurgical treatment option for dorsum sellae meningioma patients, we performed a retrospective analysis of eight microsurgery-treated patients in our set up.
Clinical data of eight microsurgery-treated dorsum sellae meningioma patients were analyzed. Dorsum sellae meningiomas were classified into 2 types based on tumor location, size, and direction of growth. Type I tumors (dorsum sellae-inferior third ventricle type, four cases) were resected by craniotomy via the frontotemporal or orbitozygomatic approach. Type II tumors (dorsum sellae-third ventricle type, 4 cases) were resected by frontal craniotomy via the transcallosal-interforniceal approach.
Complete tumor resection was achieved in all the eight patients. In Type I tumor patients, the only postoperative complication was oculomotor nerve palsy. In Type II tumor patients, the postoperative complications included hyperthermia, electrolyte imbalances, endocrinologic disturbances, and hydrocephalus. The mean follow-up was 2.1 years. Four patients returned to normal life and found a job, two were able to live independently, one required assistance, while one died.
Dorsum sellae meningioma surgery is challenging, and resection of Type II tumors is more difficult than Type I tumors. The selection of a suitable microsurgical approach based on tumor type, and the active treatment of postoperative complications are important means of increasing therapeutic efficacy.
鞍背脑膜瘤的显微外科治疗报告较少-由于位置、大小和生长方向的差异，临床表现、手术难度程度和术后后遗症也各不相同。为了寻求鞍背脑膜瘤患者的最佳显微外科治疗方案，我们对我们科室的 8 例接受显微手术治疗的患者进行了回顾性分析。
分析了 8 例接受显微手术治疗的鞍背脑膜瘤患者的临床资料。根据肿瘤位置、大小和生长方向，将鞍背脑膜瘤分为 2 型。I 型肿瘤（鞍背-下三脑室型，4 例）经额颞部或眶颧入路开颅切除。II 型肿瘤（鞍背-第三脑室型，4 例）经额部开颅经胼胝体-中间帆腔入路切除。
8 例患者均达到肿瘤全切除。I 型肿瘤患者术后唯一的并发症是动眼神经麻痹。II 型肿瘤患者术后并发症包括高热、电解质紊乱、内分泌紊乱和脑积水。平均随访时间为 2.1 年。4 例患者恢复正常生活并找到工作，2 例能够独立生活，1 例需要帮助，1 例死亡。
鞍背脑膜瘤手术具有挑战性，II 型肿瘤的切除比 I 型肿瘤更困难。根据肿瘤类型选择合适的显微外科入路，积极治疗术后并发症是提高治疗效果的重要手段。
