切换至 "中华医学电子期刊资源库"

中华脑科疾病与康复杂志(电子版) ›› 2020, Vol. 10 ›› Issue (01) : 38 -43. doi: 10.3877/cma.j.issn.2095-123X.2020.01.009

所属专题: 文献

综述

鞍结节脑膜瘤经颅手术入路的选择
陈立华1, 孙恺1, 张洪钿1, 陈文锦1, 徐如祥1,()   
  1. 1. 610072 成都,四川省医学科学院·四川省人民医院神经外科
  • 收稿日期:2019-12-25 出版日期:2020-02-15
  • 通信作者: 徐如祥

Selection of transcranial approach for tuberculum sellae meningiomas

Lihua Chen1, Kai Sun1, Hongtian Zhang1, Wenjin Chen1, Ruxiang Xu1,()   

  1. 1. Department of Neurosurgery, Sichuan Academy of Medical Sciences and Sichuan Provincial People’s Hospital, Chengdu 610072, China
  • Received:2019-12-25 Published:2020-02-15
  • Corresponding author: Ruxiang Xu
  • About author:
    Corresponding author: Xu Ruxiang, Email:
引用本文:

陈立华, 孙恺, 张洪钿, 陈文锦, 徐如祥. 鞍结节脑膜瘤经颅手术入路的选择[J]. 中华脑科疾病与康复杂志(电子版), 2020, 10(01): 38-43.

Lihua Chen, Kai Sun, Hongtian Zhang, Wenjin Chen, Ruxiang Xu. Selection of transcranial approach for tuberculum sellae meningiomas[J]. Chinese Journal of Brain Diseases and Rehabilitation(Electronic Edition), 2020, 10(01): 38-43.

鞍结节脑膜瘤(TSMs)通常采用经颅入路和内镜下经鼻蝶入路。手术入路的选择尚无统一的标准,选择哪一种入路方式除需根据肿瘤本身因素外,很大程度取决于术者对于手术入路的熟悉和掌握程度。本文针对TSMs临床上常用的手术入路,总结分析每一种入路方式的优缺点,以期掌握入路的精髓,对手术入路的选择起到有益的帮助。

Tuberculum sellae meningiomas (TSMs) are usually treated by transcranial and endoscopic transsphenoidal approaches. There is no uniform standard for the choice of surgical approach, which approach to choose depends not only on the tumor itself, but also on the the surgeon’s familiarity and mastery of the surgical approach. This article summarizes and analyzes the advantages and disadvantages of each approach for TSMs clinically commonly used surgical approaches, in order to grasp the essence of the approach and play a beneficial role in the choice of surgical approach.

[1]
Ajlan AM, Choudhri O, Hwang P, et al. Meningiomas of the tuberculum and diaphragma sellae[J]. J Neurol Surg B Skull Base, 2015, 76(1): 74-79.
[2]
Nakamura M, Roser F, Struck M, et al. Tuberculum sellae meningiomas: clinical outcome considering different surgical approaches[J]. Neurosurgery, 2006, 59(5): 1019-1028; discussion 1028-1019.
[3]
陈立华,陈凌,张秋航,等.经额外侧入路显微手术切除鞍结节脑膜瘤[J].中华神经外科杂志, 2009, 25(12): 1081-1083.
[4]
Li HC, Ling C, Li XL. Microsurgical management of tuberculum sellae meningiomas by the frontolateral approach: surgical technique and visual outcome[J]. Clin Neurol Neurosurg, 2011, 113(1): 39-47.
[5]
Hernesniemi J, Ishii K, Niemela M, et al. Lateral supraorbital approach as an alternative to the classical pterional approach[J]. Acta Neurochir Suppl, 2005, 94: 17-21.
[6]
Romani R, Laakso A, Kangasniemi M, et al. Lateral supraorbital approach applied to tuberculum sellae meningiomas: experience with 52 consecutive patients[J]. Neurosurgery, 2012, 70(6): 1504-1518; discussion 1518-1509.
[7]
Linsler S, Fischer G, Skliarenko V, et al. Endoscopic assisted supraorbital keyhole approach or endoscopic endonasal approach in cases of tuberculum sellae meningioma: which surgical route should be favored?[J]. World Neurosurg, 2017, 104: 601-611.
[8]
Jallo GI, Benjamin V. Tuberculum sellae meningiomas: microsurgical anatomy and surgical technique[J]. Neurosurgery, 2002, 51(6): 1432-1439; discussion 1439-1440.
[9]
Bassiouni H, Asgari S, Stolke D. Tuberculum sellae meningiomas: functional outcome in a consecutive series treated microsurgically[J]. Surg Neurol, 2006, 66(1): 37-44; discussion 44-35.
[10]
Schick U, Hassler W. Surgical management of tuberculum sellae meningiomas: involvement of the optic canal and visual outcome[J]. J Neurol Neurosurg Psychiatry, 2005, 76(7): 977-983.
[11]
Kinjo T, Al-Mefty O, Ciric I. Diaphragma sellae meningiomas[J]. Neurosurgery, 1995, 36(6): 1082-1092.
[12]
Goel A, Muzumdar D, Desai KI. Tuberculum sellae meningioma: a report on management on the basis of a surgical experience with 70 patients[J]. Neurosurgery, 2002, 51(6): 1358-1363; discussion 1363-1354.
[13]
Al-Mefty O. Supraorbital-pterional approach to skull base lesions[J]. Neurosurgery, 1987, 21(4): 474-477.
[14]
Basma J, Nguyen V, Sorenson J, et al. Orbitopterional approach with extradural clinoidectomy for the resection of a tuberculum sellae meningioma: adapting the strategy to the microsurgical and pathological anatomy[J]. J Neurol Surg B Skull Base, 2018, 79 (Suppl 3): S261-S262.
[15]
Arifin MZ, Mardjono I, Sidabutar R, et al. Pterional approach versus unilateral frontal approach on tuberculum sellae meningioma: single centre experiences[J]. Asian J Neurosurg, 2012, 7(1): 21-24.
[16]
Wilk A, Zielinski G, Witek P, et al. Outcome assessment after surgical treatment of tuberculum sellae meningiomas-a preliminary report[J]. Turk Neurosurg, 2016, 26(6): 824-832.
[17]
Soni RS, Patel SK, Husain Q, et al. From above or below: The controversy and historical evolution of tuberculum sellae meningioma resection from open to endoscopic skull base approaches[J]. J Clin Neurosci, 2014, 21(4): 559-568.
[18]
Margalit N, Kesler A, Ezer H, et al. Tuberculum and diaphragma sella meningioma--surgical technique and visual outcome in a series of 20 cases operated over a 2.5-year period[J]. Acta Neurochir (Wien), 2007, 149(12): 1199-1204; discussion 1204.
[19]
诸葛启钏,吴近森,潘进钱,等.经单侧额部纵裂入路显微外科切除鞍结节和鞍膈脑膜瘤[J].中华神经外科杂志, 2003, 19(1): 40-42.
[20]
Ganna A, Dehdashti AR, Karabatsou K, et al. Fronto-basal interhemispheric approach for tuberculum sellae meningiomas; long-term visual outcome[J]. Br J Neurosurg, 2009, 23(4): 422-430.
[21]
计颖,牛朝诗,程伟,等.前纵裂入路显微手术切除巨大鞍结节脑膜瘤[J].临床神经外科杂志, 2011, 8(5): 225-227.
[22]
Alvernia JE, Lanzino G, Melgar M, et al. Is exposure of the superior sagittal sinus necessary in the interhemispheric approach?[J]. Neurosurgery, 2009, 65(5): 962-964; discussion 964-965.
[1] 王强, 金光哲, 巨积辉, 王凯, 唐晓强, 吕文涛, 程贺云, 杨林, 王海龙. 超声辅助定位下游离臂内侧皮瓣在修复手指创面中的临床应用[J]. 中华损伤与修复杂志(电子版), 2024, 19(05): 393-397.
[2] 周荣, 巨积辉, 刘禹城, 杨亮, 郭礼平, 柳志锦, 王桂洋, 杨林, 程俊楠, 黄永涛, 葛成伟, 金乾衡, 曹阳, 王石, 董帅. 双侧股前外侧皮瓣修复全足皮肤脱套伤创面的血供重建方式及疗效分析[J]. 中华损伤与修复杂志(电子版), 2024, 19(04): 299-306.
[3] 刘林峰, 王增涛, 王云鹏, 钟硕, 郝丽文, 仇申强, 陈超. 足底内侧皮瓣联合甲骨皮瓣在手指V度缺损再造中的临床应用[J]. 中华损伤与修复杂志(电子版), 2023, 18(06): 480-484.
[4] 张浩, 张万福, 韩飞, 佟琳, 王运帷, 李少辉, 陈阳, 曹鹏, 官浩. 游离组织瓣治疗无吻合血管或需困难吻合血管创面的临床进展[J]. 中华损伤与修复杂志(电子版), 2023, 18(05): 442-446.
[5] 宋红霞, 吴玩呈. 内镜下甲状腺手术切口入路发展的研究进展[J]. 中华普外科手术学杂志(电子版), 2024, 18(04): 470-472.
[6] 胡剑平, 王振乾, 张龙, 尹任其, 陈涵, 赵任, 吕强. 尾侧中间联合入路与尾侧入路在腹腔镜右半结肠癌根治术中的应用对比[J]. 中华普外科手术学杂志(电子版), 2024, 18(02): 196-199.
[7] 王新团, 李博, 李栋, 马宁, 李宝平, 刘淑萍. Laennec膜入路与Glisson鞘入路在腹腔镜解剖性肝切除中的对比研究[J]. 中华普外科手术学杂志(电子版), 2023, 17(04): 418-422.
[8] 周后平, 欧廷政, 尚明铭, 袁源, 李贝贝, 姚本能. Laennec膜入路Glisson鞘外阻断联合ICG荧光影像在解剖性肝切除术中的应用(附视频)[J]. 中华肝脏外科手术学电子杂志, 2024, 13(01): 57-61.
[9] 冷昆鹏, 孟钰童, 单磊, 刘洋, 周君琳. 不同手术入路治疗肱骨远端冠状面骨折的临床疗效观察[J]. 中华肩肘外科电子杂志, 2024, 12(02): 127-134.
[10] 王竹, 王庚启, 郑军, 端磊, 徐冰, 唐熙晨, 吴泊逸, 王秋根, 王建东, 曹雷, 毕春, 邓国英. 肘关节外侧入路治疗肱骨小头骨折的治疗体会及经验总结[J]. 中华肩肘外科电子杂志, 2023, 11(03): 235-241.
[11] 李晓东, 魏云. 冠状切口额下入路治疗前颅窝巨大脑膜瘤[J]. 中华神经创伤外科电子杂志, 2023, 09(05): 318-319.
[12] 周章明, 余水, 梁张. 老年破裂前循环动脉瘤患者的急诊显微手术治疗研究[J]. 中华脑科疾病与康复杂志(电子版), 2024, 14(02): 106-111.
[13] 陈立华. 中小型前庭神经鞘瘤治疗方式选择的原则和依据[J]. 中华脑科疾病与康复杂志(电子版), 2024, 14(01): 1-7.
[14] 马洪庆, 于淼, 张建锋, 武雪亮, 胡旭华, 王光林, 孟泽松, 于滨, 王贵英. 混合入路与传统中央入路在腹腔镜直肠癌根治术中的疗效分析[J]. 中华临床医师杂志(电子版), 2023, 17(05): 545-550.
[15] 杨德红, 万宇晖, 杨凯, 陈爱林, 戴纯刚, 陈延明, 陈炳霖, 朱卿. 非优势供血侧眶上锁孔入路显微手术治疗破裂前交通动脉瘤的临床疗效[J]. 中华脑血管病杂志(电子版), 2024, 18(02): 115-120.
阅读次数
全文


摘要