乳突后枕下锁孔入路手术治疗桥小脑角区病变

Microsurgical Treatment of Cerebellopontine Angle Lesions via Suboccipital Retromastoid Keybole Approach

目的介绍应用经乳突后枕下锁孔入路手术治疗桥小脑角区病变的微创手术技术。方法采用乳突后发际内皮肤切口4～5cm,在枕部作骨窗开颅2.5cm×2cm,内镜辅助的显微手术治疗桥小脑角病变15例。结果15例桥小脑角病变中,听神经瘤8例(6例为巨大听神经瘤),桥小脑角脑膜瘤5例,均获全切除,神经功能保存完好;2例小脑前下动脉瘤准确夹闭瘤颈。结论乳突后枕下锁孔入路适合切除各种桥小脑角区肿瘤及血管性病变。

Objective To introduce a microsurgical technique for removing the lesions in the cerebellopontine angle （CPA） via suboccipital retromastoid keyhole approach. Method Through a small scalp incision and about 2 cm×2.5 cm of craniotomy, CPA lesions were resected by neuroendoscope-assisted microsurgical technique in 15 patients. Results Of 15 patients with CPA lesions, 8 suffered from acoustic neurinomas, 5 from CPA meningiomas and 2 from intracranial aneurysms. Eight cases of acoustic neurinomas （6 were giant）, and 5 cases of CPA meningiomas were totally resected, and 2 cases of aneurysms were accurately clipped. There were no severe postoperative complications. Conclusion The neuroendoscope-assisted microsurgery via sauboccipital retromastoid keyhole approach is proper for treating the CPA tumors and intracranial aneurysms.