关键词: meningioma removal olfactory groove meningiomas pterional approach surgical treatment

来  源:   DOI:10.1055/s-0033-1333618   PDF(Sci-hub)

Abstract:
Background Olfactory groove meningiomas remain surgically challenging. The common microsurgical approaches suffer from late exposure of the neurovascular structures. Conversely, the pterional approach has the advantage of early dissection of the posterior neurovascular complex. Methods We reviewed the records of patients treated for olfactory groove meningioma in our department between 1991 and 2010. A total of 61 patients underwent removal of olfactory groove meningiomas via the pterional approach. These included 58 primary and 3 recurrent tumors. Mean overall follow-up time was 122 months. Results Early exposure and dissection of the internal carotid artery, middle cerebral artery, anterior cerebral artery, and optic nerve was feasible in all cases. Complete tumor removal was achieved in 60 patients. Morbidity and mortality rates were 26% and 1.6% respectively. Postoperative complications included epileptic seizures (five patients) and cerebrospinal fluid (CSF) leak (two patients). During follow-up, we recorded three tumor recurrences. Conclusions The pterional approach appears to be an excellent solution for the treatment of olfactory groove meningiomas. Its foremost advantage is early visualization of the posterior neurovascular complex. Moreover, it allows frontal sinus preservation and timely tumor devascularization and avoids excessive brain retraction. The pterional view is familiar to most neurosurgeons and therefore the transition to this technique is fairly straightforward.
摘要:
背景嗅沟脑膜瘤在手术上仍然具有挑战性。常见的显微外科手术方法遭受神经血管结构的晚期暴露。相反,翼点入路具有早期解剖后神经血管复合体的优势。方法回顾1991年至2010年间我科嗅沟脑膜瘤患者的治疗记录。共有61例患者通过翼点入路切除嗅沟脑膜瘤。其中包括58例原发性肿瘤和3例复发性肿瘤。平均总随访时间为122个月。结果颈内动脉早期暴露和夹层,大脑中动脉,大脑前动脉,视神经在所有情况下都是可行的。60例患者实现了肿瘤完全切除。发病率和死亡率分别为26%和1.6%。术后并发症包括癫痫发作(5例)和脑脊液(CSF)漏(2例)。随访期间,我们记录了3次肿瘤复发.结论翼点入路似乎是治疗嗅沟脑膜瘤的理想方法。它的主要优点是后部神经血管复合体的早期可视化。此外,它可以保留额窦和及时的肿瘤血管离断术,并避免过度的脑收缩。翼点视图是大多数神经外科医生所熟悉的,因此向这种技术的过渡相当简单。
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