岩斜区的显微解剖与脑膜瘤的外科手术治疗

Microanatomy of the petroclival region and microsurgical treatment of petroclival meningiomas

目的通过对岩斜区的显微解剖，提高岩斜区脑膜瘤的切除程度与术后疗效。方法使用6例成人尸头标本，模拟经乙状窦前入路，在显微镜下（5～25倍）进行解剖观察；并回顾性分析8例经乙状窦前入路切除岩斜区脑膜瘤患者的临床资料。结果该入路可清楚地显示上中斜坡、内耳门和海绵窦的结构；全组患者中肿瘤全切除者4例，次全切除者2例，大部切除者2例。结论经乙状窦前入路具有手术操作距离短、视野暴露充分、早期离断肿瘤基底血供的特点，特别适用于岩斜区脑膜瘤的手术治疗。

Objective To raise the removal rate and improve postoperative efficacies for resection of petroclival meningiomas through microanatomy of the petroclival region. Methods Six adult cadaveric heads were anatomized and observed under the microscope （x5-25） mimicking the transpetrosal presigmoid approach. Meanwhile, the clinical data of consecutive 8 patients who were treated during January 2001 and June 2006 for their petroclival meningiomas through the transpetrosal presigmoid approach were retrospectively analyzed. Results The approach could expose the structures of the upper and middle clivus, internal acoustic pore and cavernous sinus clearly. Total tumor removal was achieved in 4 patients, subtotal in 2 and largely partial in 2, among the 8 patients in this study. Conclusion The transpetrosal presigmoid approach has the advantages of shorter distance of surgical operations, adequate exposure of the operative field of vision and earlier cutting of basilar blood supply of tumors, especially applicable for surgical treatment of petroclival meningiomas.