岩斜区脑膜瘤显微手术入路的改良及疗效

Modified transpetrosal presigmoid approach for microsurgical removal of petroclival meningioma

目的探讨改良经岩骨乙状窦前入路显微手术切除岩斜区脑膜瘤的疗效及手术技巧。方法采用改良经岩骨乙状窦前入路显微外科切除岩斜区脑膜瘤 11例并对其临床资料进行回顾性分析。结果肿瘤全切除 8例 ,次全切除 1例 ,大部切除 2例。本组无死亡病例 ,术后昏迷 1例 ,新出现暂时性颅神经障碍 3例 ,无脑脊液漏发生。结论改良经岩骨乙状窦前入路简便、安全 ,可充分显露岩斜区 ,有利于提高肿瘤切除程度和术后疗效 ,是岩斜区脑膜瘤手术治疗的较佳入路 ,但对术者的手术技巧和经验要求较高。

Objective To discuss the operative technique of modified transpetrosal presigmoid approach for patients with petroclival meningiomas and its outcome. Methods Eleven petroclival meningiomas treated have been microsurgically. Results In all patients, total resection was performed in 8 cases, subtotal resection in 1, and greater partial resection in 2. Temporal postoperative cranial nerve paresis occurred in 3 patients but no CSF leak, and 1 patient went coma posteratively. Conclusion This approach is simpler and safer. It can expose sufficiently the petroclival regions and facilitate tumor removal and provides good clinical outcome. So it is suitable for surgical treatment of petroclival meningiomas.