Kılıç Mustafa, Özöner Barış, Aydın Levent, Özdemir Burak, Yılmaz İlhan, Müslüman Ahmet Murat, Yılmaz Adem, Çavuşoğlu Halit, Aydın Yunus
Department of Neurosurgery, Sisli Etfal Training and Research Hospital, Istanbul, Turkey.
Sisli Etfal Hastan Tip Bul. 2019 Aug 27;53(3):240-246. doi: 10.14744/SEMB.2018.82698. eCollection 2019.
In this study, we aimed to share the surgical approaches and clinical experiences of cranio-orbital tumors, which are surgically difficult anatomies.
A total of 22 orbital tumors with extraorbital-transcranial pathology between January 2004 and December 2017 were retrospectively reviewed. Information was obtained from hospital, operation and outpatient records for this study. Preoperative demographic data, ophthalmologic examination findings, clinical and radiological findings were recorded. All patients had cranial magnetic resonance and cranial computerised tomography examinations at this time. The location of the tumor, its size and its relation to neighboring structures were recorded in the light of these examinations.
The lateral approach was performed in 12 cases. The lateral approach was performed with frontotemporal craniotomy. Because of the lateral inferior location of the tumor in three of 12 cases, zygoma osteotomy was added to classical osteotomy. In 10 cases, the anterior approach was applied and the frontal craniotomy was found sufficient in seven cases. In three cases subfrontal craniotomy was added to classical craniotomy.
The findings obtained in this study suggest that high resection rates can be achieved with appropriate surgical intervention in orbital tumors requiring a transcranial surgical approach. The most important factor in surgical planning is the location of the tumor. The size of the tumor and the expectation of the percentage of surgical removal are the other important factors. In our series, it has reached high excision ratio in most cases with low complication rate, good visual field and eye movements results.
在本研究中，我们旨在分享颅眶肿瘤的手术入路和临床经验，这些部位手术解剖难度较大。
回顾性分析2004年1月至2017年12月期间共22例伴有眶外 - 经颅病变的眼眶肿瘤病例。本研究的信息来自医院、手术及门诊记录。记录术前人口统计学数据、眼科检查结果、临床及影像学检查结果。此时所有患者均进行了头颅磁共振成像和头颅计算机断层扫描检查。根据这些检查记录肿瘤的位置、大小及其与相邻结构的关系。
12例采用外侧入路。外侧入路采用额颞开颅术。由于12例中有3例肿瘤位于外侧下方，在经典开颅术基础上增加了颧骨截骨术。10例采用前路入路，其中7例单纯额部开颅术就足够了。3例在经典开颅术基础上增加了额下入路。
本研究结果表明，对于需要经颅手术入路的眼眶肿瘤，通过适当的手术干预可实现高切除率。手术规划中最重要的因素是肿瘤的位置。肿瘤大小和预期的手术切除百分比是其他重要因素。在我们的系列研究中，大多数病例达到了高切除率，并发症发生率低，视野和眼球运动结果良好。
