颞下经小脑幕切开入路切除岩斜区脑膜瘤

Subtemporal Transtentorial Approach for the Excision of Tumors in Petroclival Region

【目的】探讨颞下经小脑幕入路切除岩斜区脑膜瘤的显微手术适应证。【方法】在显微镜下颞下经小脑幕入路切除岩斜区脑膜瘤12例。【结果】术后无死亡，肿瘤全切有9例（其中肿瘤直径小于3cm均全切，且无功能障碍），次全切3例。术后随访8～36个月，颞叶脑内小血肿2例，3例出现部分神经功能障碍，均恢复良好。【结论】颞下经小脑幕入路是切除中上斜坡平面以上、直径小于3cm的岩斜肿瘤较理想的手术入路，具有操作简单，容易暴露，易于掌握，创伤小的优点。

[Objective] To explore the surgical indications of the excision of meningiomas in petroclival region through subtemporal transtentorial approach. [Methods] Twelve cases of meningiomas in petroclival region under- went the resection via subtemporal transtentorial approach under the microscope. [Results] No patient died. Total tumor resection was performed in 9 cases（total resection of the tumor with the diameter less than 3cm and without dysfunction）. Subtotal resection was preformed in 3 cases. The 8- 36 months of follow up after the operation showed that both 2 cases of cerebral brain small hematoma in temporal lobe and 3 cases of partial neurological dys- function recovered well. [Conclusion] Subtemporal transtentorial approach for the excision of petroclival tumors a- bove clivus plane and with the diameter less than 3cm is an ideal surgical approach and has advantages such as sim- ple operation and grasp, easy exposure and minimal trauma.