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目的探讨眶上锁孔入路技术在鞍区肿瘤手术中的应用价值、手术技术及其适应证。方法回顾分析我科采用经眉弓切口的眶上锁孔入路技术治疗的15例鞍区肿瘤病人临床资料,其中男性9例,女性6例。术前主要症状为视力视野障碍及头痛。病变性质包括脑膜瘤10例,颅咽管瘤3例,垂体瘤2例。术前MRI显示肿瘤最大径20～40mm。结果本组15例病人中全切除13例,术前视力减退的13例病人中12例视力均有不同程度的改善。术后病人恢复快,没有与入路相关的术后并发症。结论眶上锁孔入路是一种安全、有效的微侵袭手术。合适病例的选择和细致的显微神经外科手术操作技术是手术顺利完成的必要条件。
Objective To investigate the value of supraorbital keyhole approach in the surgical treatment of sellar tumors, surgical techniques and indications. Methods The clinical data of 15 patients with sellar tumor who were treated with supraorbital keyhole approach through the eyebrow incision were retrospectively analyzed. There were 9 males and 6 females. The main symptoms of preoperative visual field disorders and headache. Pathological features include meningioma in 10 cases, 3 cases of craniopharyngioma, 2 cases of pituitary tumor. Preoperative MRI showed a maximum diameter of 20 ~ 40mm. Results The group of 15 patients in 13 cases of total resection, preoperative visual acuity in 13 patients, 12 cases of visual acuity have varying degrees of improvement. Postoperative patients recovered quickly, there is no postoperative complications associated with the approach. Conclusion The supraorbital keyhole approach is a safe and effective microinvasive surgery. The appropriate choice of case and meticulous neurosurgical operation techniques are necessary conditions for the successful completion of the operation.