桥小脑角脑膜瘤经枕下乙状窦后入路的显微外科手术治疗

Microsurgery Treatment of Cerebellopontine Angle Meningiomas through Suboccipital Retrosigmoid Approach

目的探讨桥小脑角脑膜瘤经枕下乙状窦后入路行显微外科手术治疗的技巧。方法回顾性分析我科2001年1月至2009年7月间诊治的16例桥小脑角脑膜瘤的临床资料。结果本组肿瘤全切12例,近全切除4例。术后颅神经功能改善9例,症状无改善或加重者7例,术后出现脑脊液漏2例,后组颅神经损伤者2例,无死亡病例。结论桥小脑角脑膜瘤可选择经枕下乙状窦后入路,术中注意对血管、神经和脑干的保护,提高切除肿瘤的技巧,预防和处理术后并发症,是保证手术疗效和术后生活质量的关键。

Objective To explore the skill of microsurgical treatment of cerebellopontine angle meningiomas through suboccipital retrosigmoid approach.Methods Clinical data from 16 cases of cerebellopontine angle meningiomas were retrospectively analyzed.Results 12 patients received total removal and 4 patients received subtotal removal.9 patients had an improved condition after the treatment.Unchanged or aggravated was noted in 7 cases,in which 2 cases had leakage of cerebrospinal fluid and 2 cases had injury of posterior cranial nerves.No patient die after the treatment.Conclusion Appropriate approaches,protection of vessels,nerves and brain stem,skills of tumor resection,properly preservation and treatment with complications,are the keys to improve therapeutical outcomes and postoperative quality of life.