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目的探讨海绵窦肿瘤的诊断与显微手术治疗效果。方法38例患者经CT及MRI诊断为海绵窦肿瘤。采用改良翼点入路、于显微镜下手术切除病变。结果31例(81.6%)肿瘤达全切除,5例(13.1%)获次全切除,余2例(5.3%)为部分切除,术后1例(2.6%)死亡。术后头痛及海绵窦综合征症状有所改善。肿瘤标本经病理学检查证实分别为脑膜瘤、神经鞘瘤、海绵状血管瘤、垂体腺瘤和胆脂瘤。33例随访8月～12(平均3.6)年,3例肿瘤复发,4例无变化或略有缩小。对其中的4例行放射外科治疗。结论MRI是诊断海绵窦肿瘤的最佳检查方法,采用改良翼点入路显微手术切除本类肿瘤,效果良好。
Objective To investigate the diagnosis and microsurgical treatment of cavernous sinus tumors. Methods Thirty-eight patients were diagnosed as cavernous sinus tumor by CT and MRI. Using modified pterional approach, under the microscope surgery to remove the lesion. Results Totally 31 cases (81.6%) had complete resection and 5 cases (13.1%) had complete subtotal resection. The remaining 2 cases (5.3%) were partially resected and one case (2.6%) died after operation. Postoperative headache and symptoms of cavernous sinus syndrome improved. Tumor specimens confirmed by pathological examination were meningioma, schwannoma, cavernous hemangioma, pituitary adenoma and cholesteatoma. Thirty-three patients were followed up from August to 12 (average 3.6) years. Three tumors recurred, and no change or slight decrease in 4 patients. Radiological treatment was performed on 4 of them. Conclusion MRI is the best method to diagnose cavernous sinus tumor. Microsurgical removal of this tumor by modified pterional approach is effective.