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为探讨鞍结节脑膜瘤的手术特点 ,作者对 1992年 5月～ 2 0 0 1年 9月的 2 9例鞍结节脑膜瘤病例进行了回顾性分析 ,其中男6例 ,女 2 3例 ,年龄 2 7～ 6 8岁 ,平均 4 6岁 ,肿瘤直径 2 0～ 8 5cm ,平均 3 4cm。首发症状为视力障碍 2 1例 (72 4 % )、头痛 7例 (2 4 1% )、癫痫 1例 (3 4 % )。 13例采用翼点或扩大的翼点入路 ,11例采用额下入路 ,3例采用额下眶上联合入路 ,2例采用双侧额下入路。全切 2 6例(89 7% ) (Simpson’sgradeⅠ) ,大部切除 3例 (10 3% ) (Simpson’sgradeII)。本组无手术死亡。作者认为对于鞍结节脑膜瘤的手术 ,除了要熟悉鞍区的解剖之外 ,还要有娴熟的显微外科技术 ,手术中要注意区分正常的结构和肿瘤的包膜 ,以保护周围的重要血管、视神经和下丘脑等结构。
In order to explore the surgical characteristics of saddle nodular meningioma, the authors retrospectively analyzed 29 cases of saddle nodular meningiomas from May 1992 to September 2001, including 6 males and 23 females , Age 27 ~ 68 years old, with an average of 46 years old, tumor diameter 20 ~ 85cm, an average of 34cm. The first symptom was visually impaired in 21 (72.4%), headache in 7 (21.4%) and epilepsy in 1 (34%). Thirteen patients were treated with pterional points or enlarged pterional approach. Eleven patients underwent frontal approach. Three patients received supratentorial supraorbital approach and two patients received bilateral inferior frontal approach. Twenty-six patients (89.7%) underwent complete resection (Simpson’s grade I) and 3 patients (103%) underwent partial resection (Simpson’s grade II). This group without surgery died. The authors believe that surgery for saddle nodular meningioma, in addition to be familiar with the anatomy of the saddle area, but also have a skilled microsurgical technique, the surgery should pay attention to distinguish the normal structure and tumor capsule to protect the surrounding important Blood vessels, optic nerve and hypothalamus and other structures.