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累及海绵窦的颅底脊索瘤。肿瘤部分切除还是根治性切除?

Skull base chordoma with cavernous sinus involvement. Partial or radical tumour-removal?

作者信息

Arnold H, Herrmann H D

出版信息

Acta Neurochir (Wien). 1986;83(1-2):31-7. doi: 10.1007/BF01420505.

Abstract

A report of eight cases of skull base chordoma is given and the related literature reviewed. From disappointing experience with incomplete tumour removal and radiation the conclusion is drawn, that radical tumour removal at the first attempt should be strived for, even if the operative risk seems to be high. Cavernous sinus invasion should not be a reason to omit operation. Loss of function of one eye appears to be justified if radical tumour removal can be achieved. Possibly, the operative strategy can be improved by combining a frontal transbasal with a frontotemporal subtemporal approach, thus creating a chance for preservation of oculomotor function even in patients whose tumour has invaded the cavernous sinus region.

摘要

本文报告8例颅底脊索瘤病例,并复习相关文献。鉴于肿瘤切除不完全及放疗效果不佳的令人失望的经验,得出的结论是,即使手术风险似乎很高,也应争取首次尝试彻底切除肿瘤。海绵窦受侵不应成为放弃手术的理由。如果能实现肿瘤的彻底切除,单眼功能丧失似乎是合理的。或许,通过将额部经颅底入路与额颞部颞下入路相结合,可以改进手术策略,从而即使在肿瘤侵犯海绵窦区域的患者中也有机会保留动眼神经功能。

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