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目的探讨小儿颅咽管瘤显微手术全切除的入路和方法。方法26例经显微手术切除的颅咽管瘤中,囊性15例,实质性11例;有钙化者13例;肿瘤直径2cm以下者2例,2～4cm10例,4.1～6cm11例,>6cm者3例。经右翼点入路切除肿瘤22例,经胼胝体前入路3例,经胼胝体-翼点联合入路1例。结果经术中观察和影像学资料证实,全切除23例,次全切除2例,大部切除1例。随访2个月～5年,恢复正常生活并参加学习者22例,需人照顾者4例。结论小儿颅咽管瘤早期诊断并行显微手术全切除,治疗效果理想;翼点入路是小儿鞍区颅咽管瘤显微手术切除的最佳入路。
Objective To investigate the approach and method of total resection of pediatric craniopharyngioma by microsurgery. Methods Twenty - six cases of craniopharyngiomas resected by microsurgical resection were 15 cases of cyst, 11 cases of cystadenoma, 13 cases of calcification, 2 cases of tumors less than 2 cm in diameter, 10 cases of 2 ~ 4 cm, 11 cases of 4.1 ~ 6 cm, 6cm in 3 cases. Twenty-two tumors were excised via the right-wing point approach. Three cases had anterior approach via the corpus callosum, and one case was treated by the corpus callosum-wing point approach. The results of intraoperative observation and imaging data confirmed that the total removal of 23 cases, subtotal resection in 2 cases, most of the resection in 1 case. Followed up for 2 months to 5 years, returned to normal life and participated in the study of 22 patients, 4 were in need of care. Conclusion The early diagnosis of craniopharyngioma in children with concurrent microsurgery resection, the treatment effect is ideal; pterional approach is the best surgical treatment of craniopharyngioma microsurgical resection in children.