Magill Stephen T, McDermott Michael W
Department of Neurological Surgery, University of California San Francisco, San Francisco, CA, United States.
Miami Neuroscience Institute, Baptist Health of South Florida, Miami, FL, United States; Division of Neuroscience, Herbert Wertheim College of Medicine, Florida International University, Miami, FL, United States.
Handb Clin Neurol. 2020;170:13-23. doi: 10.1016/B978-0-12-822198-3.00024-0.
Tuberculum sellae meningiomas are challenging tumors that can cause significant morbidity for patients because of their proximity to critical neurovascular structures. By studying the anatomy of the tuberculum, the manner in which these tumors grow and cause deficits becomes apparent, as also the challenges associated with surgical removal and management. The necessary preoperative workup and grading scales for preoperative evaluation of tuberculum meningiomas are discussed. Traditional open cranial approaches for resection are discussed and contrasted with the endoscopic endonasal approach. Finally, postoperative management, patient outcomes, and adjuvant therapy for management of residual tumor are considered.
鞍结节脑膜瘤是具有挑战性的肿瘤，由于其靠近关键神经血管结构，会给患者带来严重的发病风险。通过研究鞍结节的解剖结构，这些肿瘤的生长方式及其导致功能缺损的机制变得清晰可见，同时也能了解到与手术切除和治疗相关的挑战。本文还讨论了鞍结节脑膜瘤术前评估所需的检查及分级量表。文中探讨了传统的开颅手术切除方法，并与内镜鼻内入路进行了对比。最后，考虑了术后管理、患者预后以及残留肿瘤治疗的辅助治疗。
