Cystic Craniopharyngioma Tumor Radiotheray Treatment Of Tu Be Operationstereotactic Aspiration Ommaya Capsule Implantation

Craniopharyngioma,(craniopharyngioma), originated from the pituitary embryogenesis flat epithelial cells during the remaining, is a common congenital intracranial benign tumors, accounting for about5-7%of intracranial tumors of sellar tumors,30%. Craniopharyngioma of various age but in children and adolescents. The main cause pressure symptoms, clinical characteristics of pituitary dysfunction, increased intracranial pressure, visual acuity and visual field disorders, diabetes insipidus and neurological and psychiatric symptoms.ObjectiveCraniopharyngioma were benign tumors, but because the hypothalamus, closely around the third ventricle tumors and pituitary stalk, optic nerve, and saddle area important vascular, neural structure, make the craniotomy operation is not easy to achieve full cut, the recurrence rate is relatively high, often associated with poor prognosis, is still a great challenge neurosurgeons. Clinical treatment of the tumor varied. Including surgical operation, radiotherapy, chemotherapy, because of the particularity of the disease and its treatment. To prospective randomized controlled study. So the best clinical treatment remains controversial, and the main topic of discussion method, stereotactic radiotherapy on Ommaya implantation in benign cystic craniopharyngioma therapy.ObjectDepartment of Neurosurgery of Pingdingshan First People’s Hospital during the period from200901to201206months in hospital, confirmed the diagnosis of cystic craniopharyngioma patients with a total of23cases.13male patients,10cases of female, male than female, sex ratio of about1.3:1. Age12-57years old, average age is31.5years old. Patients with cranial CT and MRI examinations showed the tumor cavity in the saddle, the diameter of2.5-6.5cm (2cases in13cases,2.5-4cm9cases,4-5cm greater than5cm). Patients with clinical symptoms of headache, vomiting and other symptoms of high intracranial pressure, visual disturbance, psychiatric symptom development and sexual dysfunction, performance, polydipsia and polyuria, sleep disorders and other hypothalamic lesion.MethodFirst use the precise positioning of domestic Anke ASA-601S high-precision stereotactic instrument bags of craniopharyngioma puncture, puncture and put into the reservoir, the reservoir aspiration of cyst fluid after a one-time injection of radiation medicine. According to the tumor cavity size, according to the injection of radionuclide dose (mCi=27.4V/f injection of colloidal chromic phosphate, the dose to the tumor cavity3.5mCi-13.5mCi. Tumor cavity did not disappear door follow-up need further treatment according to the cavity size of the colloidal chromic phosphate quantity calculated again. ResultIn23patients with tic cyst fluid in the12.5-45ml, the clinical symptoms of patients after surgery has improved, high intracranial pressure symptoms, visual acuity was improved in different degrees, polydipsia and polyuria, amenorrhea-lactation syndrome and other endocrine symptoms, mental symptoms improved. The follow-up of6-30months, the clinical symptoms improvement. In this group of cases,8cases of aneurysm cavity disappeared or leaving only patchy calcification;9cases of aneurysm cavity continues to shrink more than2/3; in4cases after9-13months of tumor cavity was reduced after the increase, give again suction and internal radiotherapy, postoperative tumor cavity is reduced more than1/3, follow-up regular sucking hydatid fluid;2patients with tumor underwent operation treatment of substantial increase.ConclusionCystic craniopharyngioma therapy aims at removing tumor compression, prevent recurrence. Stereotactic Ommaya capsule implantation suction internal radiotherapy for cystic craniopharyngioma therapy is a kind of accurate positioning, small trauma, operation is relatively simple, effective operation method.