关键词: 眶外侧(LSO)入路, 翼点入路, 视交叉旁脑膜瘤, 显微手术, 手术结局, 美学效果

Abstract: Objective To compare the clinical effect between lateral supraorbital (LSO) approach and pterional approach for parachiasmal meningiomas.Methods A retrospective analysis of 90 patients with parachiasmal meningiomas who underwent microsurgery treatmentin our hospital,including 40 patients with LSO approach and 50 patients with pterional approach.Follow-up was completed at least 1 year postoperatively.The surgical outcomes,aesthetic outcomes associated with the approachand complications associated with the approach were analyzed retrospectively.Results There were no significant differences in preoperative brain edema,tumor characteristics,surgical resection degree,brain tissue traction injury,temporary surgical complications,postoperative visual outcome between the two groups (P>0.05).But the mean approach time,total operative time and hospital stay of LSO approach were shorter than those of pterional approach,and the blood loss during operation was also less than that of pterional approach (P<0.05).There was no temporalis muscle atrophy or visible scar outside the hairline in LSO approach,but the temporalis muscle atrophy or occurrence of visible scar outside the hairline of pterional approach were respectively 16.0% (8/50) and 86% (43/50),P<0.05.Therefore,the complete aesthetic satisfaction of LSO approach was higher than that of pterional approach (P<0.05).Conclusion LSO approach may provide a safe,rapid and less invasive exposure for parachiasmal meningiomas,and may be a reasonable alternative to the pterional approach.

Key words: Lateral supraorbital (LSO) approach, Pterional approach, Parachiasmal meningiomas, Microsurgery, Surgical outcomes, Aesthetic benefits