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本文报告20例儿童巨型颅咽管瘤显微外科手术治疗的经验。临床材料:1978～1984年作者连续手术治疗20例巨型颅咽管瘤(最大直径为5～11cm)。主诉均与鞍上肿物生长有关的症状。颅骨X线片12例有蝶鞍破坏或扩大,16例有肿瘤钙化。CT检查19例肿瘤有囊性变,仅1例肿瘤全部是实质性。11例囊液呈高密度,5例为低密度,4例为混合密度。19例有中度到重度的脑积水,14例有脑室扩张。19例进行了脑血管造影,17例有一侧或两侧颈内动脉移位,15例有A_1段升高,1/3病例颈内动脉颅内段或大脑前动脉狭窄,说明这些动脉被肿瘤包绕和压迫。手术技术:A组10例手术由作者以外的4名医生所做,B组10例由作者所做。8例双额下入路,2例经额翼部联合入路,该例系大脑前动脉未抬高属
This article reports the experience of microsurgical treatment of giant craniopharyngioma in 20 children. Clinical Materials: From 1978 to 1984, the authors underwent continuous surgical treatment of 20 giant craniopharyngiomas (maximum diameter 5 to 11 cm). The chief complaints were all related to the growth of suprasellar masses. Skull X-rays had destruction or enlargement of the sella in 12 cases and tumor calcification in 16 cases. CT examination revealed cystic changes in 19 cases, and only 1 case was all substantial. In 11 cases, the cysts showed high density, 5 cases had low density, and 4 cases had mixed density. Nineteen patients had moderate to severe hydrocephalus and 14 patients had ventricles. Cerebral angiography was performed in 19 cases, 17 cases had displacement of internal carotid artery on one side or both sides, 15 cases had elevated A1 segment, and 1/3 cases had internal carotid artery intracranial or anterior cerebral artery stenosis, indicating that these arteries were tumors. Wrap and oppression. Surgical technique: 10 cases in group A were performed by 4 doctors other than the author, and 10 cases in group B were performed by the author. 8 cases of biparietal approach, 2 cases combined by the frontal wing, this case is an anterior cerebral artery without elevation