乙状窦前入路显微手术中颞骨的处理

Transpetrosal Approach to Petroclival Tumors and Microsurgical Management of Petrous Bone

岩斜区由于解剖位置深,周围结构复杂,一直被认为是手术禁区。本文探讨乙状窦前入路显微手术切除岩斜区肿瘤术中颞骨的处理技巧。方法:总结4例头颅标本关于颞骨岩部的应用解剖,23例岩骨斜坡区肿瘤的临床表现,显微手术技巧及术后处理。结果:岩大神经是磨除颞骨岩部的重要标志,肿瘤全切16例(69.2%),无死亡,脑脊液漏2例。结论:以岩大神经为标志磨除颞骨岩部为安全手术提供了保证,适用于骑跨中后颅凹的岩斜区肿瘤。

BACKGROUND & OBJECTIVE: The aim of this retrospective study is to discuss microsurgi-cal techniques for petroclival tumors. METHODS: A microsurgical study for petrous bone was performed in four cadav-eric adult head specimens. The clinical manifestation, microsurgical techniques and postoperative management of 23 petroclival tumors were discussed. RESULTS: The great superficial petrosal nerve was an important landmark in operation on the petrous bone. Total tumor removal was achieved 16 cases(69. 2%). There was no death. There were two cases of cerebrospinal fluid leakage. CONCLUSION: The greater superficial petrosal nerve is an impor-tant landmark to guide a safe drilling on the petrous bone. This surgical approach is especially suitable for the lessons that extend into the middle and posterior fossa.