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目的 :探讨眶翼点入路在显露和切除鞍区及其附近部分病灶的优势。方法 :经眶翼点入路切除颅底肿瘤 14例 ,其中颅咽管瘤 4例 ,巨大垂体腺瘤 4例 ,海绵窦旁蝶骨嵴脑膜瘤 3例 ,颅眶沟通型神经鞘瘤 2例、淋巴瘤 1例。结果 :全部病灶均获满意显露 ,实现全切除 7例 ,次全切除 6例 ,大部分切除 1例。术后并发尿崩症 4例 ,动眼神经和外展神经损伤各 1例 ,1例右视力从术前的 0 .5 m指数变为全盲。无颅内感染 ,无脑脊液漏 ,无手术死亡。结论 :眶翼点入路使翼点入路通道向颅底进一步扩展 ,脑牵拉小 ,显著增大了鞍区及周围结构的显露 ,尤其适宜于鞍上后、鞍旁较大病灶和颅眶沟通性病灶的显露和切除
Objective: To explore the superiority of orbital wing point in revealing and resection of the lesion in the sellar region and its vicinity. Methods: 14 cases of skull base tumors were excised via orbital pterional approach, including 4 cases of craniopharyngioma, 4 cases of giant pituitary adenoma, 3 cases of cavernous sinus sphenoid ridge meningioma, 2 cases of cranio-orbital communicating schwannoma 1 case of lymphoma. Results: All the lesions were satisfactorily revealed, achieving total resection in 7 cases, subtotal resection in 6 cases and resection in 1 case. Postoperative complications of diabetes insipidus in 4 cases, oculomotor nerve and abducens nerve injury in 1 case, 1 case of right visual acuity from preoperative 0.5m index into full blindness. No intracranial infection, no cerebrospinal fluid leakage, no operative death. CONCLUSION: The insertion of pterygoid pterional point causes the pterional approach to extend further to the base of the skull, which results in the small stretch of the brain, which significantly increases the exposure of the saddle area and its surrounding structures, especially for the suprasellar and parasellar lesions Orbital communication lesions revealed and resection