三叉神经鞘瘤的显微外科治疗  

Microsurgery for trigeminal schwannomas

作　　者：梁勇[1] 赵明光[1] 徐岩 王晓刚[1] 林军[1] 

机构地区：[1]中国人民解放军沈阳军区总医院神经外科,辽宁沈阳110015 [2]阜新矿务集团总医院神经外科,辽宁阜新123000

出　　处：《中国微侵袭神经外科杂志》2005年第10期447-448,共2页Chinese Journal of Minimally Invasive Neurosurgery

摘　　要：目的探讨不同类型三叉神经鞘瘤的最佳手术入路。方法回顾性分析10例三叉神经鞘瘤的临床资料,其中2例颅后窝型采用枕下乙状窦后入路切除,1例颅中窝型和7例哑铃型则在Brainlab神经导航下采用改良Dolenc入路切除。结果本组均获得全切除。出院时Karnofsky评分100分6例,90分4例。平均随访32个月,均无复发。结论三叉神经鞘瘤行显微手术切除疗效好。神经导航对选择损伤最小的入路和避免神经、血管损伤具有指导意义。Objective To investigate the optimal skull base approach for the removal of different types oftrigeminal schwannomas. Methods The clinical materials of 10 patients with trigeminal schwarmomas were analyzed retrospectively. Tumors of 2 cases predominantly in the cerebellopontine angle were resected via retrosigmoid suboccipital approach; 1 tumor predominantly in the middle cranial fossa and 7 dumbbell-shaped tumors were resected via modified Dolenc approach with the guidance of Brainlab neuronavigation system. Results Total tumor removal was achieved in all patients, and there was no surgical mortality. The KPS scores were 100 in 6 cases, and 90 in 4. No patient experienced tumor recurrence after a median follow-up of 32 months, ranged from 6 to 60 months. Conclusion The best treatment for trigeminal schwannomas is skull base surgery. The Brainlab neuronavigtion system can provided guidance on determining minimally invasive approaches and avoiding injuries of critical neurovascular structures.

关 键 词：三叉神经鞘瘤 颅底 神经导航 

分 类 号：R739.4[医药卫生—肿瘤]