改良翼点-经颞叶-经小脑幕入路手术切除三叉神经鞘瘤  

Modified pterional transtemporal transtentorial approach for trigeminal schwannomas

作　　者：乔梁[1] 王汉东[1] 马驰原[1] 李杰[1] 胡志刚[1] 高超超[1] 周渊[1] 凌海平[1] 王强[1] 

机构地区：[1]南京军区南京总医院神经外科,210002

出　　处：《中国微侵袭神经外科杂志》2017年第7期301-303,共3页Chinese Journal of Minimally Invasive Neurosurgery

基　　金：基金项目:江苏省科教强卫工程医学重点学科(编号:ZDXKB2016023)

摘　　要：目的总结改良翼点-经颞叶-经小脑幕(modified pterional transtemporal transtentorial,MPTT)入路手术切除三叉神经鞘瘤的疗效及经验。方法回顾性分析31例经MPTT入路切除三叉神经鞘瘤病人的临床资料,包括颅中窝型10例,颅中后窝骑跨型21例。结果肿瘤全切除29例,次全切除1例,大部分切除1例。所有病人随访3~90个月,1例病人肿瘤复发伴巨大囊肿再次手术。其余病人头晕、头痛等症状消失,面部麻木、感觉减退状况好转。结论 MPTT入路是切除颅中窝型、颅中后窝骑跨型三叉神经鞘瘤合适的入路选择,该入路暴露充分,视角佳,全切除率高。Objective To summarize the surgical outcome and experience of the modified pterional transtemporal transtentorial （MPTT） approach for the resection of trigeminal schwannomas. Methods Clinical data of 31 trigeminal schwannomas patients who underwent surgery via MPTT approach were analyzed retrospectively. There were 10 patients with tumors in the middle cranial fossa and 21 with dumbbell-shaped tumors in middle and posterior cranial fossa. Results Gross total resection was achieved in 29 patients, subtotal resection in 1 patient and partial resection in 1. The patients were followed up for 3 to 90 months. The tumor recurred in one patient with giant cyst, who received the second operation. The preoperative symptoms were improved in the remaining patients including the disappearance of dizziness and headache and the improvement of facial numbness and hypesthesia. Conclusions MPTT approach is proper for the resection of trigeminal schwannomas in the middle cranial fossa and dumbbell-shaped tumors in the middle and posterior cranial fossa, and could adequately expose the tumor with an excellent view angle, thus obtaining a high resection rate.

关 键 词：三叉神经鞘瘤 入路 改良翼点-经颞叶-经小脑幕 颅中后窝骑跨型 颅中窝型 

分 类 号：R739.4[医药卫生—肿瘤] R651.11[医药卫生—临床医学]