Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China; Beijing Neurosurgical Institute, Capital Medical University, Beijing, China.
Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
World Neurosurg. 2023 Jul;175:e336-e343. doi: 10.1016/j.wneu.2023.03.083. Epub 2023 Mar 24.
The clinical features and surgical techniques related to patients undergoing resection of extracranial large primary intraosseous meningiomas are studied.
The clinical characteristics, treatment, and prognosis of 6 patients with primary intraosseous meningiomas larger than 5 cm in diameter were retrospectively reviewed in the 10th Neurosurgical Department of Beijing Tiantan Hospital, Capital Medical University.
Five males and one female (18-57 years old) suffered from large primary intraosseous meningiomas. The main symptoms were headaches accompanied by head swelling. CT showed irregular thickening of the bone diploe with increased density and uneven surface. MRI showed partial bone destruction of the skull, local thickening of the internal and external plates, shell and palisade changes of the external cranial plate, and enhancement of the adjacent meninges. A horseshoe or coronary incision plus the "Mercedes-Benz" incision were chosen to expose the skull bone, and drilling was performed in the normal skull bone at the transition zone between abnormal and normal skull bone. After drilling, the sub flap dura was dissected, the hyperplastic skull was dissected with a milling cutter, and the residual tumor was then resected. A cranioplasty was performed 6 months to 1 year later.
Surgical treatment and precise perioperative management can achieve a better prognosis for large intraosseous meningiomas.
研究颅外大型原发性骨内脑膜瘤患者的临床特征和手术技术。
回顾性分析首都医科大学附属北京天坛医院神经外科 10 病区 6 例直径大于 5cm 的原发性骨内脑膜瘤患者的临床特点、治疗和预后。
5 例男性，1 例女性，年龄 18-57 岁，均为大型原发性骨内脑膜瘤患者。主要症状为头痛伴头部肿胀。CT 显示骨板不规则增厚，密度增高，表面不均匀。MRI 显示颅骨局部破坏，内外板局部增厚，颅骨外板呈贝壳和栅栏样改变，脑膜增强。选择马蹄形或冠状切口加“奔驰”切口暴露颅骨，在异常颅骨与正常颅骨交界处的正常颅骨上钻孔。钻孔后，分离皮下骨瓣，用铣刀切除增生颅骨，然后切除残余肿瘤。术后 6 个月至 1 年行颅骨修补术。
手术治疗和精确的围手术期管理可以为大型骨内脑膜瘤患者带来更好的预后。
