桥小脑角脑膜瘤的诊断与显微手术治疗(附65例报告)

Diagnosis and microsurgical treatment of 65 patients with cerebellopontine angle meningiomas

目的探讨65例桥小脑角脑膜瘤的诊断及其显微手术治疗。方法回顾性分析我科1988年10月～2005年10月间诊治的65例桥小脑角脑膜瘤的临床资料。结果桥小脑角脑膜瘤临床表现类似听神经瘤，本组肿瘤全切12例，近全切32例，部分切除21例，术后γ刀53例。术后颅神经功能改善41例；无改善或加重24例，其中死亡2例。40例随访3个月～15年，34例恢复良好，6例死亡，5例复发。结论桥小脑角脑膜瘤依临床表现及影像学检查多可早期定位与定性诊断；术中选择适当的手术入路，妥善处理和保护血管、神经、脑干等，术后正确处理并发症，是提高手术疗效和患者术后生活质量的关键。

Objective To discuss the diagnosis, microsurgical approaches and results of 65 patients with cerebellopontine angle （CPA） meningiomas. Methods 65 patients underwent surgical removal of histologically confirmed CPA meningiomas between October 1988 and October 2005. A retrospective analysis was performed on these patients with regard to diagnosis, microsurgical approaches and long-term results. Results The clinical manifestations of meningioma of the CPA are similar to those of acoustic neuroma. Complete resection was done in 12 patients, 32 were subtotal resection in 32 patients and part resection in 21 patients. Among them, 53 patients received γ-knife therapy after operation. The postoperative neurological status was improved in 41 patients, remained unchanged or aggravated in 24, 2 deaths occurred. 40 patients were followed up from 3 months to 15 years. 34 patients rehabilitated and 6 died. 5 tumors were recurrent. Conclusion Early diagnosis can usually be achieved according to the clinical manifestation and radiography image. Appropriate approaches during operation and properly treatment after operation can significantly improve the outconme and decrease the complication.