额颞-颞下入路治疗中颅凹型三叉神经鞘瘤疗效分析  

Microsurgical treatment of trigeminal neurinoma under frontotemporal arch-subtemporal approach

作　　者：陈东[1] 石军伟[1] 熊文德[1] 

机构地区：[1]大连市中心医院神经外科,辽宁大连116033

出　　处：《大连医科大学学报》2010年第3期329-331,共3页Journal of Dalian Medical University

摘　　要：[目的]探讨经额颞-颞下入路对中颅凹型三叉神经鞘瘤的手术优点。[方法]回顾分析5例经额颞-颞下入路手术切除中颅凹型三叉神经鞘瘤临床资料。4例全切,1例大部切,海绵窦内有残留。2例断颧弓。[结果]术后病人临床症状不同程度改善,其中1例病人术后出现一过性动眼神经麻痹,术后1月恢复;1例出现脑脊液漏,经抗炎治疗和腰大池置管引流痊愈。本组无死亡病例。1例大部切病人术后行γ刀治疗,复查MR I,残存肿瘤无增大。[结论]经额颞-颞下入路对切除中颅凹型三叉神经鞘瘤具有创伤小,距离近,显露好等优点。[Objective] To investigate the effect in middle cranial fossa trigeminal neurinoma under frontotemporal arch-subtemporal approach.[Methods] Five patients with trigeminal neurinoma resection via subtemporal approach were retrospectively analyzed.[Results] Total resection was achieved in 4 patients and subtotal resection was performed in 1 patient with small portion neurioma remained in the cavernous sinuses.The cranial nerve deficits were improved after operation.Transient oculomotor paralysis happened in 1 case.Leakage of cerebrospinal fluid occurred in another patient,which was fully recovered by lumber draining and antibiotic therapy.[Conclusion] Subtemporal approach can provide better exposure of these tumors with minimal brain retraction.The treatment for middle cranial fossa trigeminal neurinoma is complete microsurgical removal of the tumor through frontotemporal arch-subtemporal approach.

关 键 词：三叉神经鞘瘤 颞下入路 显微外科 

分 类 号：R739.4[医药卫生—肿瘤]