目的探讨显微外科手术切除和伽玛刀治疗海绵窦区脑膜瘤的有效性。方法回顾性分析2002年1月至2007年1月来我院接受治疗并获得完全随访资料的91例海绵窦脑膜瘤患者的治疗情况。41例肿瘤最大直径小于2～3cm,体积较小,无明显神经系统症状及颅内压增高表现,选择行伽玛刀治疗。50例肿瘤最大直径大于3cm,压迫、粘连视神经、视交叉,或脑干受压,伴有显著神经系统症状或颅内高压症状,先行显微外科手术治疗,术后残余患者补充伽玛刀治疗。治疗实施前后均进行眼肌功能评估。结果随访36～96个月。41例患者直接行伽玛刀治疗,有3例伽玛刀治疗后分别于第9、14、18个月出现水肿反应;有2例患者于治疗后第5年及第6年复发;伽玛刀治疗前及随访期间Biglan眼肌功能分级中优秀+良好的比率分别为63.4%、75.6%。50例手术患者,4例全切患者无一例复发;46例术后肿瘤残余补充伽玛刀治疗患者,3例分别于第4年、第5.5年及第7年复发;术前、术后短期及随访期间Biglan眼肌功能分级中,优秀+良好的比率分别为38%、44%和52%。结论海绵窦区脑膜瘤全切困难,对于体积较小的海绵窦区脑膜瘤,单纯伽玛刀治疗效果好,可作为主要的治疗手段,对于体积较大的海绵窦区脑膜瘤,采取手术和伽玛刀治疗,可有效降低海绵窦区脑膜瘤术后复发率,提高、保持患者的生存质量。 Objective To investigate the effectiveness of microsurgical resection and gamma knife in the treatment of cavernous sinus meningioma. Methods The clinical data of 91 patients with cavernous sinus meningiomas who were treated in our hospital from January 2002 to January 2007 and were followed up completely were retrospectively analyzed. 41 cases of the largest tumor diameter less than 2 ~ 3cm, smaller, no obvious neurological symptoms and increased intracranial pressure performance, choose to line gamma knife treatment. 50 cases of tumor diameter greater than 3cm, oppression, adhesion optic nerve, optic chiasm, or brainstem compression, accompanied by significant neurological symptoms or symptoms of intracranial hypertension, the first microsurgical treatment of postoperative residual patients with gamma knife treatment . Eye function assessment was performed before and after treatment. The results were followed up for 36 to 96 months. 41 patients underwent direct gamma knife treatment, with three cases of gamma knife treatment, respectively, at the 9th, 14th, and 18th months of edema reaction; two patients relapsed at the fifth and sixth years after treatment; Gamma The excellent + good ratio of Biglan oculomotor function grading before and during the knife treatment were 63.4% and 75.6% respectively. There was no recurrence in 50 cases of surgical patients and 4 cases of complete resection. 46 cases of postoperative tumor remnant gamma knife treatment, 3 cases of recurrence in 4 years, 5 years and 7 years respectively; preoperative and postoperative short-term And during the follow-up Biglan oculomotor function grading, excellent + good rates were 38%, 44% and 52% respectively. Conclusions It is difficult to cut meningioma in cavernous sinus region completely. For meningiomas in small cavernous sinus region, simple gamma knife treatment is effective and can be used as the main treatment. For larger cavernous sinus meningioma, surgery and Gamma knife treatment, can effectively reduce the cavernous sinus meningioma recurrence rate, improve and maintain the quality of life of patients.