Semiconductor laser microsurgery in the surgery of skull base meningiomas

Keywords:skull base meningiomas, semiconductor lasers, micro-surgery

Objective: To investigate the semiconductor laser microsurgery in the surgery of skull base meningiomas.
Methods: 18 cases of skull base meningiomas according to the tumor site using one or both frontal approach, modified pterional approach, post-rock ear bone surgery such as tentorial approach channels to be removed, respectively, intraoperative application of High power semiconductor lasers in combination with microsurgical technique.
Results: 14 cases of cutting, sub-total resection in 4 cases, no operative death and severe complications.
Conclusion: The application of semiconductor laser micro-surgery purposes of skull base meningiomas increased rate and total removal of tumor surgery.

Key words: skull base meningiomas, semiconductor lasers, micro-surgery
Meningioma of the skull base is the most frequent sites, accounting for about 40% of the total incidence of meningiomas, to sphenoid ridge, tuberculum sellae, olfactory groove, and anterior cranial fossa, cerebellopontine angle, petroclival region and other parts of common surgical more difficult. Skull base meningiomas were treated in our department, 18 cases of skull base meningiomas were treated over the same period about 31.6%, respectively, using semiconductor laser micro-surgery, and achieved good effect, analysis of reports are as follows.

1 clinical materials
1.1 General information: The group of 5 males and 13 females. Aged 29 to 69 years, mean 47.1 years, duration of 3 weeks to 10 years, an average of 25.2 months.
1.2 parts of skull base meningiomas occurred: five cases of sphenoid ridge, tuberculum sellae 3 cases, 3 cases of cerebellopontine angle, petroclival region in 4 cases, 2 cases of olfactory groove, anterior cranial fossa in 1 case.
1.3 The main clinical manifestations: headache, dizziness in 14 cases, blurred vision and decreased visual acuity in 9 cases, 5 cases of hearing loss, facial numbness in 6 cases, one or both diminished sense of smell, loss of 3 cases, eye movement disorder, three cases of diplopia , 7 cases of ataxia, cranial nerve disorder in 7 cases.
1.4 Pathological types: endothelial 5 cases, fiber cell type in 3 cases, sand size in 3 cases, vascular type 2 cases, mixed type in 3 cases, no typing in 2 cases.
1.5 Imaging examination: This group, 18 patients underwent CT examination, 12 cases and for MRI examination. CT scan for a more uniform high-density, boundary clear tumor images, enhanced scan showed markedly enhanced tumor, mostly spherical or spherical, a small number of lobulated. Tumor size 6cm 7 cases, MRI showed a long T1 short-T2 signal, to enhance the tumor significantly enhanced. 9 routine cerebral DSA, including two cases of another line of the main blood supply to tumor embolization.