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作者对过去九年中,运用颅底术式治疗38例颅内动脉瘤的成功经验作了介绍。在所有经治疗病例中,仅1例有眼睑不完下垂,2例脑脊液漏。 根据动脉瘤的不同部位,采用不同术式的颅底经路,分述如下: 一.前交通动脉瘤—额下经眶入路(Subfrontal and transorbital) 沿发际内过中线额颞部切口,额颞骨瓣成形,距中线保留1cm额骨,分离眶周各缘,颞骨部分咬除后,作眶骨切除(眶板前后径必须保留2.5～3cm,以避免术后眼球内陷)切开硬膜,轻抬同侧额叶,即可显露双侧大脑前动脉A_1、A_2段及其动脉瘤。
The author of the past nine years, the use of skull base surgery for the treatment of 38 cases of intracranial aneurysms have introduced the successful experience. Of all the treated cases, only 1 had eyelid droop and 2 had cerebrospinal fluid leak. According to the different parts of the aneurysm, using different surgical approach skull base road, are as follows: I. Anterior communicating artery aneurysm - the amount of the next through the orbital approach (Subfrontal and transorbital) along the intramural frontal frontotemporal incision, Frontotemporal bone flap is formed, 1cm frontal bone is reserved from the midline, periorbital margins are separated, part of the temporal bone is bite removed, orbital bone resection (anterior or posterior orifice of the orbital plate must be retained 2.5 ~ 3cm, in order to avoid postoperative eye retraction) Cut hard Membrane, light lift the ipsilateral frontal lobe, bilateral cerebral anterior artery can be revealed A_1, A_2 segment and its aneurysm.