[Transcranial operation for cranio-orbital communicating tumors and its complications]

To investigate the procedure of transcranial operation via pterional approach for cranio-orbital communicating tumors, to improve surgery skills, to summarize the incidence of main complications and to discuss tips for avoiding damage of the normal orbital tissues.

Pterional approach was adopted for the operation. After the medial orbital wall or lateral orbital wall was bitten with rongeur and the orbital roof was removed, the extraocular muscles at orbital apex were separated and protected. The head of condenser was used to freeze the tumor, and the tissue around the tumor was separated until the tumor was extirpated. In cases where the tumor penetrated the dura mater and invaded the brain, surgery was performed by neurosurgeons.

In 37 cases, 32 cases undertook total resection of tumors and palliative resection was performed in 5 cases due to severe tumor invasion of the cavernous sinus or sphenoid sinus. Of the 37 cases, 28 cases were benign tumors and accounted for 75.67% of total cases (28/37); 9 were malignant tumors and accounted for 24.32% (9/37). Pathological examination showed that 11 cases were meningioma which was the most common type of tumor and accounted for 29.73% of total cases(11/37). The most common complication was injury to extraocular muscles, which occurred in 21 cases and accounted for 56.76% of all cases (21/37). The most serious complication was vision loss, which occurred in 4 cases and accounted for 10.81% of all cases (4/37).

Resection of cranio-orbital communicating tumors via pterional approach provides a wide observation field and facilities exposing tumors. Protecting important tissues in posterior orbital region will result in less postoperative complications.