经改良颞下岩骨入路切除岩斜区肿瘤  

Modified subtemporal transtentorial approach for resection of petroelival tumors

作　　者：曾春[1] 张施远[1] 蒋永明[1] 

机构地区：[1]四川省遂宁市中心医院神经外科,629000

出　　处：《临床神经外科杂志》2017年第6期441-445,共5页Journal of Clinical Neurosurgery

基　　金：四川省卫计委科研基金(140106)

摘　　要：目的探讨应用改良颞下岩骨入路切除岩斜区肿瘤的手术方法和疗效。方法回顾性分析19例采用经改良颞下岩骨入路显微手术治疗的岩斜区肿瘤患者的临床资料和手术要点。结果肿瘤全切除15例,次全切除4例。术后病理检查证实,脑膜瘤13例,神经鞘瘤6例。术后2例患者出现暂时性癫痫发作,4例患者出现轻度面部麻木,1例患者出现轻度面瘫;没有出现术区明显血肿、脑脊液漏及伤口感染的患者,无死亡病例。术后随访3个月至4年,这5例患者的神经功能障碍均得到不同程度恢复。18例患者术后无肿瘤复发,1例次全切除患者术后复发。结论改良经颞下岩骨入路为一种操作简捷、安全有效的手术方式;对于切除内听道以内、桥延沟以上,特别是跨中后颅窝的中上岩斜区肿瘤手术操作具有一定优势。Objective To investigate the surgical method and effect of resection of petroclival tumors via modified subtemporal transpetrosal approach. Method The clinical data and operation points of 19 patients who had petroclival tumors andhad accepted microsurgery via modified subtemporal transpetrosal approach were analyzed retrospectively. Results There were 13 cases of meningiomas and 6 schwannomas. Tumors were totally removed in 15 cases and subtotally removed in 4. After the operation,2 cases had temporary seizure,4 had mild facial numbness and 1 had mild facial paralysis. No intracranial hematoma,CSF leak or infection occurred,and no dead case. All patients had been followed up from 3 months to 4 years,the 5 patients＇ neurological dysfunction had recovered in varying degrees. 1 patient with subtotal resection had a relapse,the other 18 cases had not recurred. Conclusions The modified subtemporal transpetrosal approach is a simple,safe and effective surgical method. It has certain advantege for the mid-superior petroclival tumors within the internal auditory canal and above the bridge pontomedullary sulcus,especially for tumors spaning the middle and posterior cranial fossa simultaneously.

关 键 词：显微外科手术 岩斜区 颞下经岩骨入路 

分 类 号：R739.91[医药卫生—肿瘤]