显微外科治疗幕上下岩骨后脑膜瘤

Microsurgical management of supra- and infra-tentorial meningioma of the posterior petrous bone.

目的探讨侵犯幕上下岩骨后脑膜瘤的手术治疗经验。方法对21例显微外科手术治疗幕上下岩骨后脑膜瘤患者的临床资料进行回顾性分析。结果21例患者中行枕下乙状窦后入路肿瘤SimpsonⅠ级切除16例，SimpsonⅡ级切除5例，术中根据情况将增生岩骨、受侵小脑幕一并切除。术后并发症主要为轻度面神经麻痹和听力下降。平均随访3．2年，所有患者均正常工作生活，无肿瘤复发。结论应用显微外科手术技术全切除幕上下岩骨后脑膜瘤，可取得良好的临床效果。

Objective To explore the microsurgical experience of supra- and infra-tentorial meningioma of the posterior petrous bone. Methods Clinical data of 21 patients who had undergone microsurgical treatment were retrospectively reviewed. Results All patients underwent surgical treatment via a suboccipital retrosigmoid approach, and hyperostosis of the petrous bone and infiltrated cerebellar tentorium were resected intraoperatively. Tumor resection was categorized as Grade I in 16 patients,Grade U in 5 patients,according to the Simpson classification system. The main postoperative complications included slight facial paresis and hearing function deterioration. The mean follow-up time was 3.2 years. All patients resumed normal daily activity and no tumor recurrence happened. Conclusions Total resection for supra- and infra-tentorial meningioma of the posterior petrous bone can be achieved with an excellent prognosis by use of mierosurgical technique.