43例小脑桥脑角脑膜瘤诊疗体会  

Microsurgical Resection of Cerebellopontine Angle Meningiomas:A Report of 43 Cases

作　　者：葛志强[1] 张世明[1] 王中[1] 周幽心[1] 虞正权[1] 崔岗[1] 李向东[1] 刘建刚[1] 

机构地区：[1]苏州大学附属第一医院神经外科,215006

出　　处：《中国临床神经科学》2013年第2期151-154,共4页Chinese Journal of Clinical Neurosciences

基　　金：江苏省医学重点学科基金项目(编号:xk2007227)

摘　　要：目的总结小脑桥脑角(CPA)脑膜瘤的诊断和显微手术切除的体会。方法回顾性分析2007年7月至2012年7月收治的接受显微外科手术治疗并经病理证实为CPA脑膜瘤43例患者的临床资料。结果 CT和MRI是CPA脑膜瘤诊断的重要影像学方法,但是需要与听神经鞘瘤鉴别。43例均在全麻下经乙状窦后入路行显微镜下肿瘤切除术。SimpsonⅠ级切除16例,SimpsonⅡ级切除18例,SimpsonⅢ级切除9例。32例术后随访3个月至3年,19例恢复良好,9例基本同术前,2例偏瘫,2例植物生存。32例中2例肿瘤复发。结论头颅CT、MRI是CPA脑膜瘤的主要诊断依据。手术切除肿瘤是治疗CPA脑膜瘤的首选方法;术中运用神经内镜、神经电生理监测可提高肿瘤全切除率、提高患者治愈率。Aim To discuss the clinical features of cerebellopontine angle（CPA） meningioma and microsurgical treatment experiences of CPA meningioma. Methods 43 cases of CPA meningioma treated in our hospital and diagnosed by pathology from July, 2007 to July, 2012 were retrospectively analyzed. Results CT and MRI are important imaging techniques to distinguish CPA meningioma form acoustic tumor. All patients were treated via suboccipital retrosigmoid approach. According to Simpson resection of tumors grading, grade I resection of the tumors were achieved in 16 cases, grade II in 18 cases, grade III in 9 cases. 32 patients were followed up from 3 months to 3 years. 19 patients rehabilitated and 9 cases remained unchanged, 2 cases with hemiplegia, 2 cases persistent vegetative state. 2 tumors recurrentamong 32 patients. Conclusion The images of head CT and MRI are important clues for the diagnosis of CPA meningioma. Surgery treatment is the first choice method for CPA meningioma. It is possible to increase the overall resection rate of CPA meningioma and the curative rate of patients with the application of neuroendoscope and intraoperative neurophysiological monitoring.

关 键 词：脑膜瘤 小脑桥脑角 显微手术 面神经 听神经 保护 

分 类 号：R739.41[医药卫生—肿瘤]