翼点锁孔显微手术治疗儿童外侧裂区蛛网膜囊肿临床观察Pterional keyhole microsurgery for the treatment of sylvian arachnoid cysts in children
李天豪;张鹏;孙红卫;闫东明;郭社卫;赵培超;刘学友;王蒙蒙;罗玉茹;
摘要(Abstract):
目的探讨翼点锁孔显微手术治疗儿童外侧裂区蛛网膜囊肿的临床效果。方法回顾2016-03―2019-03郑州大学第一附属医院收治的25例经翼点锁孔显微手术治疗的外侧裂区蛛网膜囊肿患者的临床资料、手术情况及临床结果。结果平均随访时间24.3个月,19例有症状的患者术后均改善。影像学检查囊肿消失3例,缩小19例,无变化3例,有效率88%。术后无死亡,3例出现无症状性硬膜下积液,对症治疗后均得到较好控制。结论经翼点锁孔显微手术治疗儿童侧裂区蛛网膜囊肿是一种微创、安全、有效的方法。
关键词(KeyWords): 翼点锁孔;显微手术;外侧裂;蛛网膜囊肿;儿童
基金项目(Foundation): 河南省教育厅基金项目(编号:18A320059)
作者(Author): 李天豪;张鹏;孙红卫;闫东明;郭社卫;赵培超;刘学友;王蒙蒙;罗玉茹;
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参考文献(References):
- [1] ZADA G,KRIEGER M D,MCNATT S A,et al.Pathogenesis and treatment of intracranial arachnoid cysts in pediatric patients younger than 2 years of age[J].Neurosurg Focus,2007,22:E1.
- [2] AL-HOLOU W N,YEW A Y,BOOMSAAD Z E,et al.Prevalence and natural history of arachnoid cysts in children[J].J Neurosurg Pediatr,2010,5:578-85.
- [3] GALASSI E,TOGNETTI F,GAIST G,et al.CT scan and metrizamide CT cisternography in arachnoid cysts of the middle cranial fossa:classification and pathophysiological aspects[J].Surg Neurol,1982,17:363-369.
- [4] GODANO U,MASCARI C,CONSALES A,et al.Endoscope-controlled microneurosurgery for the treatment of intracranial fluid cysts[J].Childs Nerv Syst,2004,20:839-841.
- [5] KWIATKOWSKA K,HALABUDA A,RYBUS J,et al.Cognitive disorders in a patient with an arachnoid cyst of the sylvian fissure and improvement after surgical treatment:Case description[J].Appl Neuropsychol Child,2019,8:182-186.
- [6] RENNERT R C,LEVY D M,STEINBERG J A,et al.Keyhole Microsurgical Middle Fossa Arachnoid Cyst Fenestration:2-Dimensional Operative Video[J].World Neurosurg,2020,137:93.
- [7] 王子德,朱玉辐,陆冬,等.后颅窝蛛网膜囊肿临床治疗分析[J].中国实用神经疾病杂志,2020,23(9):798-802.
- [8] BERESFORD C,HALL S,SMEDLEY A,et al.Prenatal diagnosis of arachnoid cysts:a case series and systematic review[J].Childs Nerv Syst,2020,36:729-741.
- [9] PASSERO S,FILOSOMI G,CIONI R,et al.Arachnoid cysts of the middle cranial fossa:a clinical,radiological and follow-up study[J].Acta Neurol Scand,1990,82:94-100.
- [10] DE KEERSMAECKER B,RAMAEKERS P,CLAUS F,et al.Outcome of 12 antenatally diagnosed fetal arachnoid cysts:case series and review of the literature[J].Eur J Paediatr.Neurol,2015,19:114-121.
- [11] SHIGEMORI M,OKURA A,TAKAHASHI Y,et al.New surgical treatment of middle fossa arachnoid cyst[J].Surg Neurol,1996,45:189-192.
- [12] ALI M,BENNARDO M,ALMENAWER S,et al.Exploring predictors of surgery and comparing operative treatment approaches for pediatric intracranial arachnoid cysts:a case series of 83 patients[J].J Neurosurg Pediatr,2015,16:275-282.
- [13] ZADA G,KRIEGER M,MCNATT S,et al.Pathogenesis and treatment of intracranial arachnoid cysts in pediatric patients younger than 2 years of age[J].Neurosurg Focus,2007,22:E1.
- [14] HALL S,SMEDLEY A,RAE S,et al.Clinical and radiological outcomes following surgical treatment for intra-cranial arachnoid cysts[J].Clin Neurol Neurosurg,2019,177:42-46.
- [15] LEVY M L,WANG M,ARYAN H E,et al.Microsurgical keyhole approach for middle fossa arachnoid cyst fenestration[J].Neurosurgery,2003,53:1138-1144;discussion 1144-1145.
- [16] AZAB W A,ALMANABRI M,YOSEF W,et al.Endoscopic treatment of middle fossa arachnoid cysts[J].Acta Neurochir (Wien),2017,159:2313-2317.
- [17] AL-HOLOU W N,TERMAN S,KILBURG C,et al.Prevalence and natural history of arachnoid cysts in adults[J].J Neurosurg,2013,118:222-231.
- [18] MA G,LI X,QIAO N,et al.Suprasellar arachnoid cysts in adults:clinical presentations,radiological features,and treatment outcomes[J].Neurosurg Rev,2020 Jul 25.
- [19] MORI K,YAMAMOTO T,HORINAKA N,et al.Arachnoid cyst is a risk factor for chronic subdural hematoma in juveniles:twelve cases of chronic subdural hematoma associated with arachnoid cyst[J].J Neurotrauma,2002,19:1017-1027.
- [20] KIM K N,LEE J Y,PHI JH,et al.Long-term outcome of large sylvian arachnoid cysts:the role of surgery has been exaggerated[J].J Neurosurg Pediatr,2020,undefined:1-7.
- [21] SANDVIK U,ADOLFSSON T,JACOBSON DN,et al.Cognition in Children with Arachnoid Cysts.[J].J Clin Med,2020,9:undefined.
- [22] DI ROCCO F,R JAMES S,ROUJEAU T,et al.Limits of endoscopic treatment of sylvian arachnoid cysts in children[J].Childs Nerv Syst,2010,26:155-162.
- [23] ALI M,BENNARDO M,ALMENAWER S A,et al.Exploring predictors of surgery and comparing operative treatment approaches for pediatric intracranial arachnoid cysts:a case series of 83 patients[J].J Neurosurg Pediatr,2015,16:275-282.