Meckel腔脑膜瘤临床分型与微创手术治疗策略  

Clinical type and minimal invasive treatment strategies of Meckel's cave meningiomas

作　　者：陈立华[1] 徐如祥[1] 魏群[1] 李运军[1] 李文德[1] 赵浩[1] 高进宝[1] 于斌[1] 

机构地区：[1]北京军区总医院附属八一脑科医院,100700

出　　处：《中国微侵袭神经外科杂志》2015年第3期97-100,共4页Chinese Journal of Minimally Invasive Neurosurgery

基　　金：首都医学发展基金重点项目(编号:2009-8098)

摘　　要：目的探讨Meckel腔脑膜瘤的临床分型、手术入路选择和微创手术治疗策略,提高肿瘤全切除率和改善术后疗效。方法回顾性分析经显微手术切除的17例Meckel腔脑膜瘤病人的临床资料。根据肿瘤的起源部位和侵袭方向将Meckel腔脑膜瘤分为三型：Ⅰ型3例;Ⅱ型5例;Ⅲ型9例。Ⅰ型脑膜瘤采用前颞下-经硬膜内入路,Ⅱ型和Ⅲ型脑膜瘤采用乙状窦后-内听道上入路。结果肿瘤SimpsonⅠ级切除11例,SimpsonⅡ级切除6例。术后无新增脑神经损伤,无手术相关死亡病例。随访3~86个月,未见肿瘤复发。结论 Meckel腔脑膜瘤的分型有助于选择最佳的手术入路。乙状窦后-经内听道上入路适用于Ⅱ型和Ⅲ型Meckel腔脑膜瘤。Objectives To explore the clinical types, surgical approach and minimal invasive surgical strategies of Meckel＇s cave meningiomas, increase the rate of total resection and improve the postoperative outcome. Methods Clinical data of 17 Meckel＇s cave meningioma patients undergoing microsurgical resection were analyzed retrospectively. These tumors were classified according to the origin and progressive direction in three different types, including 3 type I tumor, 5 type Ⅱ and 9 type Ⅲ. The type I tumors were resected via anterior inferotemporal-intradural approach, type Ⅱ and Ⅲ tumors via retrosigmoid trans-suprameatal approach. Results Simpson I resection was achieved in Ⅱ patients and Simpson Ⅱ resection in 6. There was neither mortality with relation to operation nor new cranial nerve deficit. No tumor recurred during 3 to 86 months of follow-up period. Conclusions Clinical classification of Meckers cave meningioma helps to select the best surgical approach. Retrosigmoid trans-suprameatal approach is suitable for exposure and removal of types Ⅱ and IU Meckel＇s cave meningioma.

关 键 词：脑膜瘤 MECKEL腔 入路 前颞下-经硬膜内 入路 乙状窦后-内听道上 显微外科手术 

分 类 号：R739.45[医药卫生—肿瘤]