远外侧-乙状窦前联合人路治疗岩斜区脑干腹侧巨大占位  

Far lateral -combined presigmoid approach in microsurgicai treatment for giant petroclival and ventral brain stem lesions

作　　者：吴斌[1] 周忠清[1] 石祥恩[1] 杨庆哲[1] 宋明[1] 

机构地区：[1]首都医科大学第十一临床医学院、北京三博脑科医院神经外科,100093

出　　处：《中华神经外科杂志》2011年第6期680-683,共4页Chinese Journal of Neurosurgery

摘　　要：目的 探讨远外侧-乙状窦前联合入路在广泛侵及斜坡-脑干腹侧巨大肿瘤和椎-基底动脉复杂巨大动脉瘤的显微外科手术治疗中的应用。方法回顾性分析应用远外侧-乙状窦前联合入路显微手术治疗的2例椎-基底巨大动脉瘤和1例巨大颅内外沟通之颈静脉孔区颈静脉球瘤，并广泛侵犯岩斜及鞍旁区域，对此3例临床、影像资料及手术入路进行研究分析。结果1例巨大肿瘤近全切除，出现饮水呛咳，声音嘶哑，术后10d好转，但周围性面瘫较术前加重，术后3个月复查恢复至术前水平。例2、3巨大椎一基底动脉瘤患者术后饮水呛咳均有好转，行走正常。结论远外侧一乙状窦前联合入路对于侵蚀全斜坡的巨大颅底肿瘤或椎一基底动脉巨大动脉瘤的治疗是一种全新的安全有效的手术方法。Objective To study the outcome of the far lateral - combined presigmoid approach in microsurgical treatment for patients with giant petroclival tumors and vertebral - basilar artery aneurysms. Methods The clinical features, imaging data, surgical approach, outcome of operation and postoperative complications of two cases of giant vertebral - basilar artery aneurysms and one giant intra - and extracranial petroelival glomus jugulare tumor resected via the far lateral - combined presigmoid approach were analyzed retrospectively. Results Subtotal resection of the tumor was achieved in one patient. Postoperatively, this patient had drinking irritating, phonal hoarseness and peripheral facial paralysis. The first two complications of this patient were fully recovered 10 days later, and his facial paralysis was transiently getting worse, and recovered to basic level three months after surgery. Drinking irritating of two cases of giant vertebral - basilar artery aneurysms was fully recovered without limb paralysis. Conclusions The far lateral - combined presigmoid approach is a safe and effective minimal invasive surgical treatment for patient with giant petroclival tumors and vertebral - basilar artery aneurysms.

关 键 词：远外侧-乙状窦前联合入路 岩斜区巨大肿瘤 椎-基底巨大动脉瘤 

分 类 号：R651.1[医药卫生—外科学]