岩斜区脑膜瘤的手术治疗与显微解剖研究  

Microsurgical anatomy of the petroclival meningiomas

作　　者：黄广龙[1] 漆松涛[1] 张喜安[1] 张嘉林[1] 石瑾[1] 王晓艳[1] 邱晓瑜[1] 莫益萍[1] 

机构地区：[1]南方医科大学南方医院神经外科,广州510515

出　　处：《中华神经医学杂志》2013年第7期670-674,共5页Chinese Journal of Neuromedicine

摘　　要：目的探讨岩斜区脑膜瘤的最佳手术入路，以提高岩斜区肿瘤的手术疗效。方法收集南方医科大学南方医院自2009年4月至2011年10月收治的35例累及海绵窦的岩斜区脑膜瘤患者资料进行分析，患者均采用颞下经岩骨前部入路显微外科治疗；同时选择10例20侧解剖标本进行3种改良切12I模拟微创颞下经岩骨前部手术人路研究：总结患者的影像学资料、临床表现及手术疗效，结合实验标本解剖数据分析不同手术人路优缺点。结果本组患者肿瘤全切28例．次全切6例，大部分全切1例；术后症状和体征完全消失17例，症状较术前减轻10例，颅神经损害症状同术前5例，出现新神经功能障3例。结合解剖学数据发现，3种改良切口对不同类型岩斜区肿瘤均可以达到良好的暴露。结论颞下经岩骨前部人路是岩斜区脑膜瘤的优先选择人路。Objective To explore the microsurgical approach for petroclival tumors to improve the surgical efficacy. Methods The clinical data of 35 patients with petroclival meningiomas, underwent microsurgery through subtemporal anterior transpetrosal approach in our hospital from April 2009 to October 2011, were analyzed retrospectively. For anatomical information, the micro-neurosurgical anatomical dissection, observation and measurement were performed under microscope by mimicking the subtemporal anterior transpetrosal approach on twenty sides of ten adult formalin-fixed cadaveric heads. The advantages and disadvantages of the three approaches were compared. Results Of these 35 patients, 28 received total resection of the tumors, 6 subtotal resection and 1 partial resection. After the operation, the symptoms and signs disappeared in 17 patients; the symptoms got relief in l0 patients; the symptom of cranial nerve was unchanged in 5, and the new neurological disturbance appeared in 3. Good exposure could be achieved in these different types of petroclival tumors by the three approaches. Conclusion The subtemporal anterior transpetrosal approch is the best choice for patients with petroclival tumors.

关 键 词：岩斜区 脑膜瘤 显微神经外科 解剖 颞下经岩骨前部入路 

分 类 号：R739.45[医药卫生—肿瘤]