扩大外侧入路切除枕大孔前及前外侧肿瘤  

An extreme lateral approach to removal tumours located anterior or anterolateral portion of the foramen magnum

作　　者：赵孟尧[1] 郝文清[1] 周晓平[1] 

机构地区：[1]第二军医大学长海医院神经外科

出　　处：《中华神经外科杂志》1995年第5期284-287,共4页Chinese Journal of Neurosurgery

摘　　要：枕大孔区前方及前侧方肿瘤常规的后方入路具有较多的困难和危险，前方经口、咽入路，仅适用于此区硬脑膜外病变。经扩大的枕下侧方入路，将软组织分离范围扩大，乳突部分切除，颅后窝去骨到乙状窦外缘及颈静脉孔外缘，枕大孔后缘及侧方切除，寰椎椎弓切除暴露椎动脉。这样能从侧方显露枕大孔前方及侧前方肿瘤，手术者能看到肿瘤与脑干的冠状界面，后组颅神经、脑干、椎基动脉得以显露和保护。报告４例手术病例，并结合解剖及文献复习，介绍此手术方法、优点及适应证。Abstract Tumors located at the anterior of the foramen magnum are usually benign, but with more risk in surgery. The conventional posterior approach,although adequate for the managment of most of this tumors , can sometimes result in incomplete removal of the tumor and exacerbation of the neurological deficits. The transoral and transcervical approach provid a direct route to the tumor, but the opening is deep and small, in case of large tumor it is inadequate. In the present report, an extreme lateral approach to the anterior portion of the foramien magnum for removal of intradural tumor in four patients is described. This approach provided a lateral exposure of tumor/stem interface,thus permitting safe dessection without retraction of the medulla.

关 键 词：脑肿瘤 枕大孔区 外科手术 侧入路 

分 类 号：R739.91[医药卫生—肿瘤] R730.56[医药卫生—临床医学]