远外侧入路切除枕大孔腹外侧区肿瘤

Resection of tumors in ventral lateral portion of foramen magnum via far lateral approach

目的探讨枕大孔腹外侧区肿瘤手术技巧,以合理的入路、最小的创伤获得最大的显露、更高的切除率。方法选择斜坡和枕大孔区腹外侧肿瘤12例,其中神经鞘瘤5例,胆脂瘤3例,脑膜瘤2例,室管膜瘤1例,脊索瘤1例。运用远外侧入路及其改良法显微镜下切除该区位于低位脑干和上颈髓腹外侧不同性质的肿瘤。结果手术全切除8例,次全切及大部分切除4例。均恢复良好。结论远外侧入路是切除枕大孔腹外侧区病变的一种良好的入路。

Objective To study the operative techniques of resecting the tumors in the ventral lateral portion of foramen magnum via a desirable approach to achieve minimal trauma, larger exposure size and higher resection rate. Methods A group of 12 patients, including 5 cases of neurilemoma, 3 of cholesteatoma, 2 of meningioma, 1 of ependymoma and 1 of chordoma, were chosen based on their tumor location, the clivus or ventral lateral region of foramen magnum. The different tumors were removed with improved microscopic operative skills via far lateral approach. Results Total removal was made in 8 cases, subtotal or most removal in 4 cases. The prognosis in all cases was well. Conclusion Far lateral approach is preferable for resecting the lesions in the ventral lateral region of foramen magnum.