颅内胆脂瘤的诊断与显微手术治疗

Diagnosis and Microsurgical Treatment of the Intracranial Cholesteatoma

目的提高颅内胆脂瘤的诊断水平与手术治疗效果。方法总结分析218例颅内胆脂瘤的临床征象、诊断方式、显微手术入路与疗效。结果203例（93．1％）肿瘤获全切除，余15例（6．9％）因肿瘤包膜与丘脑或脑干粘连紧密而行次全切除。5例（2．3％）于手术后2周内因脑干缺血、水肿或肺部感染死亡。176例获长期随访（平均5．6年），其中170例（96．6％）恢复良好，3例（1．7％）肿瘤有复发，需行再次手术切除。结论采用CT或MRI进行诊断并用显微手术治疗颅内胆脂瘤，是一种行之有效的方法。

To improve the diagnostic level and surgical curative effect of the intracranial cholesteatoma. Methods Analyse and summarize the clinical materials included the clinical rnain manifestations,diagnstic modss, microsurgical approach, and outcom of 218 patients with the intracranial choesteatoma . Results There were 203 cases(93. 1% ) total removal of the tumor. In the remaining 15 pahents(6. 9% ), adhesion hghily to the thalamus or brain stem made only subtotal removal of the capsule of tumor. 5 patients were died (2. 3% )because of brain stem ischenda or edema, and lung infechon within two weeks petoperahvely. Longterm follow-up review(mean 5. 6 years) in 176 patients reveded good recovery of 170 patients(96. 6% ), contmeted with a 1. 7% (3 cases) late recurrence rate after operations. This patients with recurrence of tumor need to treat by again operative management. Conclusion It is effective method by using the CT or MRI to diagose and microsurgical technique to remove cholesteatoma for these patients.