文章：

优化前颅底脑膜瘤的手术治疗策略：影像学评估、关键手术考量与风险缓解措施

Optimizing Surgical Management of Anterior Skull Base Meningiomas: Imaging Modalities, Key Surgical Considerations, and Risk Mitigation Strategies

原文发布日期：14 March 2025

DOI: 10.3390/cancers17060987

类型: Article

开放获取: 是

英文摘要：

Skull base meningiomas present considerable challenges in surgical management due to their proximity to critical neurovascular structures. Anterior skull base meningiomas encompass olfactory groove, supra- and parasellar, anterior sphenoid ridge, cavernous sinus, and spheno-orbital tumors. The success of surgical resection and the likelihood of complications are influenced by several key factors, including the presence of an intact arachnoid plane, tumor size and consistency, peritumoral brain edema, cranial nerve involvement, vascular encasement, and invasion of critical areas such as the optic canal or cavernous sinus. These factors not only affect the feasibility of gross total resection but also play a pivotal role in determining functional outcomes and postoperative recovery. With the vast array of imaging modalities available, selecting the most appropriate investigations to assess these parameters and tailoring surgical strategies accordingly remain complex tasks. This review examines the critical surgical parameters, identifies the most effective imaging modalities for evaluating each, and provides key insights into how this analysis can guide surgical decision-making, mitigate risks, and minimize complications.

摘要翻译： 

颅底脑膜瘤因其毗邻重要神经血管结构，在手术治疗中构成显著挑战。前颅底脑膜瘤包括嗅沟、鞍区及鞍旁、前床突、海绵窦以及蝶眶区肿瘤。手术切除的成功率及并发症发生可能性受多个关键因素影响，包括蛛网膜平面的完整性、肿瘤大小与质地、瘤周脑水肿程度、颅神经受累情况、血管包绕程度以及对视神经管或海绵窦等重要区域的侵犯。这些因素不仅影响肿瘤全切除的可行性，更对患者功能预后及术后恢复具有决定性作用。当前影像学技术种类繁多，如何选择最适宜的检查手段以评估上述参数，并据此制定个体化手术策略仍是临床面临的复杂课题。本文系统探讨了影响手术的关键参数，明确了评估各参数最有效的影像学方法，并深入阐释了如何通过综合分析指导手术决策、降低手术风险并减少并发症发生。

原文链接：

Optimizing Surgical Management of Anterior Skull Base Meningiomas: Imaging Modalities, Key Surgical Considerations, and Risk Mitigation Strategies