远外侧入路手术治疗枕大孔区腹侧脑膜瘤

Surgery via far-lateral approach for the meningiomas in the foramen occipitale magnum

目的探讨枕大孔区腹侧脑膜瘤手术入路及术后管理。方法回顾性分析16例枕大孔区脑膜瘤患者的临床特征、手术入路及预后。结果采用远外侧入路术式行肿瘤全切除11例,次全切除5例。术后症状改善9例,相仿6例,加重1例。脑神经障碍是最常见的并发症。随访16例,平均随访4.3年,复发1例。9例正常生活(56.3%)。结论远外侧入路是枕大孔区腹侧脑膜瘤的合适手术路径。术后管理可影响预后。

Objective To explore the surgical approach and postoperative management for meningiomas in the foramen occipitale magnum. Methods The clinical features,surgical approach and prognosis of 16 patients with foramen occipitale magnum meningioma were retrospectively analyzed. Results With far-lateral approach,total resection was performed in 11 cases and subtotal in 5 cases.The symptoms were improved in 9 cases,similar in 6 cases and exacerbated in 1 case.The most frequent postoperative complication was nerve pareses of the Ⅸ-Ⅻ cranial nerves.All patients were followed-up for a mean duration of 4.3 years,which showed that tumor recurrence was seen in 1 patient and lived normally in 9 cases（56.3%）. Conclusion The far-lateral approach is suitable for surgical resection of meningiomas in the foramen occipitale magnum.The preoperative preparation and postoperative management may affect the prognosis.