小脑桥脑角乙状窦前迷路后幕上幕下联合入路的手术技术与临床应用

Combined presigmoid retrolabyrinthine and supra-infratentorial approach to the cerebellopontine angle

本文介绍一种联合入路术式行小脑桥脑角区肿瘤切除术。本术式切除 Trautmann 氏三角骨质,横断岩上窦,游离出横窦及乙状窦并将此二窦牵向内后下方,从而在不切断横窦的前提下,使迷路后、幕上和枕下三个入路的术野完全沟通,连同一片,达到显露范围广而又保留重要结构的目的。本文将介绍并讨论手术方法、局部解剖及32例临床应用等情况。

32 cases of cerebellopontine angle tumors wereoperated by combined presigmoid retrolabyrinthine andsupra-infratentoriat approach.26 of them were acous-tic neuromas.The topography,operative method andresults are mentioned.The main points of this routeare(1)Removing most part of the mastoid and the ba-sic part of the petrosal portion of the temporal bone(including Trautmann's triangle)(2)Ligate and cut offthe superior petrosus sinus(3)Mobilized transversussinus and sigmoid sinus,inward,backward and down-ward.In this way,the supratentorial retrolabyrinthineand subtentorial approach are united into one large op-erative field.It may be beneficial to complete removeof the tumors and protect the surrounding importantstructures.This style of operation may be studied fur-ther.