改良经岩骨乙状窦前入路显微外科治疗岩斜区肿瘤

Modified transpetrosal presigmoid approach for microsurgical removal of petroclival tumors

目的探讨岩斜区肿瘤经改良岩骨乙状窦前入路显微外科治疗的手术特征及并发症。方法回顾性分析经显微手术治疗的9例岩斜区肿瘤,对肿瘤临床和影像学特征、手术入路、手术切除技巧及术后常见并发症的处理进行研究。结果肿瘤全切除7例,近全切除1例,大部切除1例。术后一过性失语1例,脑水肿2例,周围性面瘫1例,脑脊液耳漏1例,腰穿引流后好转。无死亡病例。结论改良经岩骨乙状窦前入路可充分暴露岩斜区肿瘤及其周围结构,是岩斜区肿瘤的较佳手术入路。

Objective ： To discuss the operative technique , advantage and postoperative complications in 9 patients with petroclival tumors treated with modified transpetrosal presigmoid approach. Methods ： Retrospective analysis of 9 patients with petroclival tumors was made. Results ： Total resection was performed in 7 patients , subtotal resection in 1 , and greater partial resection in one. Major postoperative complications included temporal aphasia （1 patients） , cerebral edema （2） , facial nerves palsies（ 1） and cerebrospinal fluid leakage （ 1 case）. Conclusions： Modified transpetrosal presigmoid approach can expose sufficiently the petroclival regions and perroclival tumors. So it is suitable for surgical treatment of petroclival tumors.