桥小脑角病变显微手术828例分析  

Research of Causes of Cerebellopontine Angle Diseases in 828 Patients

作　　者：徐兆水[1] 赵可[1] 唐林卡[1] 陈玲[1] 黎业生[1] 唐乔[1] 

机构地区：[1]解放军第181医院耳鼻咽喉科头颈外科,广西桂林541002

出　　处：《临床军医杂志》2007年第1期47-49,共3页Clinical Journal of Medical Officers

摘　　要：目的总结桥小脑角病变828例显微手术的经验,并探讨其致病原因。方法经乙状窦后入路进入桥小脑角,在手术显微镜下对有关神经构成压迫的各种病灶分别给予相应的减压等处理。结果桥小脑角病变828例中,顺利完成手术治愈出院者820例(占99.03%),因多血管压迫无法减压、严重粘连不能分解、巨大肿瘤界限不清、术野渗血无法操作及病人术中不合作等因素而中止手术者6例,术中并发严重张力性气颅转科治疗2例。术中发现因责任血管压迫758例,占91.55%;肿瘤22例,占2.66%;蛛网膜粘连48例,占5.8%。结论桥小脑角病变828例,致病因素以责任血管压迫为主,部分为肿瘤压迫,而蛛网膜粘连致病者亦占相当比例;蛛网膜粘连是引起舌咽神经痛的重要因素。Objective To summarize 828 case reports of the patients with cerebellopontine angle micmrgy and research the causes of their diseases. Methods The instrument entered the cerebellopontine angle via retrosigmoid approach. The nerves oppressed with different niduses were released under microscope. Results Out of 828, 820 patients （ 99.03% ） with cerebellopontine angle diseases were operated successfully and discharged. The operation was discontinued in six ones because of some factors, such as oppression by blood vessels, serious adhesion, tremendous tumor without clear border, bleeding in the operative area and lacking of patients＇ cooperation. Two ones were complicated with serious pneumocephalus and were transfered to other departments. During the operation, 758 ones （91.55%） were found to suffer from oppression of the blood vessels, 22 （2.66%） from oncothlipsis and 48 （5.8%） from arachnoid adhesion. Conclusion The oppression of the blood vessel is the main cause of cerebellopontine angle diseases. Oncothlipsis and arachnoid adhesion also occupy a large proportion. Arachnoid adhesion acts as an important cause of glossopharyngeal neuralgia.

关 键 词：乙状窦后入路 桥小脑角 显微手术 神经根减压术 病因 

分 类 号：R651.11[医药卫生—外科学]