骑跨中后颅窝哑铃型三叉神经鞘瘤的手术治疗  

Surgical treatment of dumbbell trigeminal schwannomas straddling the middle and posterior fossae

作　　者：李峤[1] 段磊[1] 袁国强[2] 张祎年[1] 杨虎[1] 牛亮[1] 代军强[1] 赵国明[1] 潘亚文[1] 

机构地区：[1]兰州大学第二医院神经外科,甘肃兰州730030 [2]兰州大学神经病学研究所,甘肃兰州730030

出　　处：《中国耳鼻咽喉颅底外科杂志》2017年第4期310-314,共5页Chinese Journal of Otorhinolaryngology-skull Base Surgery

基　　金：甘肃省卫生行业项目(GSWSKY-2015-58;GSWSKY-2014-31)

摘　　要：目的探讨两种入路切除向中后颅窝侵犯的哑铃型三叉神经鞘瘤的手术效果。方法对两种入路治疗的24例中后颅窝哑铃型三叉神经鞘瘤的手术效果进行分析,手术入路选择为幕上额颞开颅为基础辅以硬膜间(Dolenc)入路,幕下开颅枕下乙状窦后开颅为基础的硬膜下入路。结果经幕上组入路共16例,全切7例,次全切9例,经幕下组入路共8例,肿瘤全切6例,次全切2例。结论额颞硬膜间(Dolenc)入路残存率、死亡率较经枕下乙状窦后入路低,但肿瘤全切率及神经功能保留率较幕下入路低。Objective To investigate the therapeutic effect of two surgical approaches for trigeminal schwannomas straddling the middle and posterior fossae. Methods Clinical data of 24 patients with trigeminal schwannomas simultaneously straddling the middle and posterior fossae were analyzed retrospectively. The adopted surgical approaches included supratentorial frontal-temporal interdural approach with Dolenc technique and infratentorial subdural retrosigmoid approach. Results Of all the patients, 16 undergoing tumor resection via supratentorial approach and $ via infratentorial approach. Total and subtotal tumor resection was achieved in 7 and 9 of the 16 patients undergoing tumor resection via supratentorial approach, while total and subtotal tumor resection was achieved in 5 and 3 of the 8 cases via infratentorial approach. Conclusion Although Dolenc approach has low disability rate and fatality rate, retrosigmoid approach may increase the possibility of nerve function preservation and achieve high total resection rate.

关 键 词：哑铃型三叉神经鞘瘤 功能保留 硬膜间入路 硬膜下入路 

分 类 号：R651.1[医药卫生—外科学]