Niwa J, Uede T, Ohtaki M, Ibayashi Y, Tanabe S, Hashi K
Department of Neurosurgery, Sapporo Medical University.
No Shinkei Geka. 1996 Apr;24(4):321-8.
Prognosis after total removal of craniopharyngiomas via the frontobasal interhemispheric approach is reviewed. Seventeen patients with craniopharyngiomas were operated on in Sapporo Medical University Hospital between January, 1985 and December, 1993. In eleven patients, lamina terminalis was incised and in the last six patients, it was left intact. Tumors were completely resected in all patients. After removal of the tumor, hypothalmic--pituitary functions, visual functions and psychometric functions were examined. Two of the 17 cases showed hypernaturemia and fourteen (82%) had permanent DI. Fourteen patients are receiving DDAVP and all are receiving endocrine replacement. Of fourteen patients who had disturbance of their visual acuity, nine (64%) improved. Five of six patients (83%) who presented visual field defect showed improvement in their deficits. Thirteen patients had a psychometric assessment at the time of follow-up examination. Full-scale intelligence quotient scores were distributed as follows: three above 120, five between 90 and 109, three between 70 and 79 and two below 69. Four (32%) had some impairment of memory. Concerning the QOL after total removal of craniopharyngiomas via the frontobasal interhemispheric approach, thirteen patients (76%) are leading normal lives, and three (18%) are leading nearly normal lives but require some help to overcome mild deficits. One (6%) has suffered a significant handicap.
回顾经额底纵裂入路全切除颅咽管瘤后的预后情况。1985年1月至1993年12月间，北海道医科大学医院对17例颅咽管瘤患者进行了手术。11例患者切开终板，后6例患者终板保持完整。所有患者的肿瘤均被完全切除。肿瘤切除后，对下丘脑 - 垂体功能、视觉功能和心理测量功能进行了检查。17例患者中有2例出现高钠血症，14例（82%）发生永久性尿崩症。14例患者正在接受去氨加压素治疗，且均接受内分泌替代治疗。14例视力障碍患者中，9例（64%）视力改善。6例视野缺损患者中有5例（83%）视野缺损得到改善。13例患者在随访检查时进行了心理测量评估。全量表智商得分分布如下：3例高于120，5例在90至109之间，3例在70至79之间，2例低于69。4例（32%）存在一定程度的记忆障碍。关于经额底纵裂入路全切除颅咽管瘤后的生活质量，13例患者（76%）过着正常生活，3例（18%）过着近乎正常的生活，但需要一些帮助来克服轻微缺陷。1例（6%）有严重残疾。
