岩斜坡区脑膜瘤的手术治疗

Surgical treatment of petroclival meningiomas

目的探讨岩斜坡区脑膜瘤的治疗方案，提高患者生存期及生存质量。方法同顾总结1998年3月至2010年5月的32例岩斜坡区脑膜瘤患者的临床资料，其中10例采用颞下经小脑幕入路，9例采用经岩骨乙状窦前入路，13例采用经枕下乙状窦后入路。结果肿瘤全切除21例，次全切除11例，围手术期死亡1例。结论针对肿瘤不同的生长位置采用合适的入路呵提高手术切除的治愈率，降低并发症的发生率，其中经枕下乙状窦后入路具有副损伤小、且能够显露整个斜坡区的优点，可以广泛应用于岩斜坡区脑膜瘤的切除中。

Objective To investigate the surgieal strategy, increase survival time and improve life quality for petroclival meningioma patients. Method The clinical data of 32 petroclival meningioma patients were retrospectively analyzed. Surgical approach was classified as following： Poppen approach （10 cases）; transpetrosal presigmoid approach （9 cases）; suboccipital retrosigmoid approach （13 cases）. Results The tumor was totally removed in 21 patients, sub -totally resected in 11 patients. Postoperative death oceured in 1 patient. Conclusions Tumorindividualized approach improves cure rate and decreases the complication rate. Suboccipital retrosigmoid approach contributed to expose clival structures, prevent iatrogenie damages and underlined its necessity in extensive application for surgical treatment of petroclival meningioma.