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目的探讨海绵窦区肿瘤切除的手术入路,以提高手术全切率,降低残障率。方法对14例海绵窦内肿瘤行硬膜下入路切除5例,行硬膜外入路切除9例,比较两种入路的方法及疗效。结果行硬膜下入路者中全切除2例,大部切除3例;术后出现新的神经功能障碍4例。行硬膜外入路者中全切除5例,次全切除3例,大部切除1例;术后出现新的脑神经功能障碍3例,其中1例完全恢复。结论针对不同类型的肿瘤及生长特性,选择适当的手术入路和显微神经外科技术,可有效提高全切率,降低残障率。
Objective To investigate the surgical approach of tumor resection in cavernous sinus area to improve the rate of surgical removal and reduce the rate of disability. Methods Fourteen cases of cavernous sinus tumors were excised by subdural approach in 5 cases. Epidural approach was performed in 9 cases. Methods and curative effects were compared between the two approaches. Results Subdural approach in total excision of 2 cases, most of the resection in 3 cases; 4 cases of new neurological dysfunction. In the epidural route, 5 cases were totally resected, 3 cases were subtotally resected and 1 case was mostly resected. There were 3 cases of new brain dysfunction after operation, of which 1 case recovered completely. Conclusion Different types of tumors and growth characteristics, selection of appropriate surgical approach and microsurgical neurosurgical techniques, can effectively improve the rate of full-cut, reduce the rate of disability.