经颧弓颞下硬膜间入路手术治疗颅中窝海绵窦区肿瘤  

Resection of cavernous sinus tumor in the middle cranial fossa via transzygomatic subtemporal interdural approach

作　　者：罗正祥[1] 张岩松[1] 赵鹏来[1] 杨坤[1] 陈永严[1] 黄庆玖[1] 刘永[1] 

机构地区：[1]南京医科大学附属脑科医院神经外科,210029

出　　处：《中国微侵袭神经外科杂志》2015年第4期145-147,共3页Chinese Journal of Minimally Invasive Neurosurgery

基　　金：南京市卫生青年人才培养工程(编号:QRX11198)

摘　　要：目的探讨经颧弓颞下硬膜间入路切除颅中窝海绵窦区肿瘤的价值。方法回顾性分析15例颅中窝海绵窦区肿瘤的病例资料,均采用经颧弓颞下硬膜间入路治疗。结果肿瘤全切除13例,次全切除2例。术后病理：三叉神经鞘瘤14例,脑膜瘤1例。术前症状改善或无明显变化13例,加重2例,术后出现新增脑神经麻痹2例。随访时间3个月-3年,全部病例未见肿瘤复发。无死亡病例。结论经颧弓颞下硬膜间入路切除颅中窝海绵窦区肿瘤术野显露佳,对神经、血管、脑组织的保护较好,可作为此区域神经鞘瘤的首选方案。Objective To investigate the value of transzygomatic subtemporal interdural approach for the resection of tumors involving the cavernous sinus. Methods The clinical data of 15 patients with tumors involving the cavernous sinus resected via the transzygomatic subtemporal interdural approach were analyzed retrospectively. Results Total resection was achieved in 13 patients and subtotal resection in 2. The pathological examination revealed 14 trigeminal schwannomas and 1 meningioma. The symptoms improved or unchanged in 13 patients and aggravated in 2 after surgery. The new postoperative cranial nerve palsy was observed in 2 patients. There was no recurrence and no operation-related mortality during the followed up from 3 months to 3 years. Conclusions The transzygomatic subtemporal interdural approach can provide the favorable surgical exposure for resection of the tumors especially trigeminal schwannomas involving the cavernous sinus and can produces protective effect for adjacent nerves, vessels and cerebrum tissues, thus can be preferred as a first option.

关 键 词：颅窝 中 MECKEL腔 海绵窦 神经鞘瘤 脑膜瘤 

分 类 号：R739.4[医药卫生—肿瘤]