颧颞入路切除中颅底肿瘤

Zygomatic-temporal Approach for Tumor Resection in Middle Cranial Fossa

目的 探讨颧颞入路对中颅底肿瘤的疗效。方法 对中颅窝脑膜瘤 9例 ,颅咽管瘤、脑膜肉瘤及神经鞘瘤各 1例 ,采用颧颞入路手术 ,取下颧弓以扩大中颅窝底视野。对肿瘤长入后颅窝者 ,切开小脑天幕 ,切除天幕下肿瘤 ,对向前颅底及眶内生长者 ,以扩大的颧颞眶入路手术。结果 中颅底肿瘤全切 6例 ,次全切 3例 ,大部切除 3例。肿瘤残留与肿瘤侵犯海绵窦、包绕颈内动脉、脑干受浸润有关。结论 颧颞入路可有效地适用于中颅底肿瘤切除术。

Objective To analyze zygomatic-temporal approach with microsurgical resection in 12 cases with tumors in middle cranial fossa,in order to raise the surgical effect.Methods Twelve patients with tumors in middle cranial fossa:9 meningioma;1 craniopharyngioma;1 meningoblastoma;1 neuroma.Among these,2 with tumors cross frontal and middle fossa invading into orbit,3 with tumors cross middle and posterior fossa.With zygomatic-temporal approach,zygomatic arch was removed to expand the visual field for middle cranial fossa.For intraorbital tumors,an extensive removal of orbital margin was required.For infratentorial tumors,cerbellar tentorium was incised.Two patients were treated with linear accelerator radiotherapy and one was given supply vessel embolism with radiointevention in order to reduce tumor blood supply.Results Total removing was achieved in 6 cased (50%),subtotal removing 3(25%)and mainly removing 3(25%).The residual tumors involved with cavernous sinus,brain stem infiltrated and internal carotid artery circumvented.Conclusion Zygomatic-temporal approach is valid to be used for removing tumors in middle cranial fossa.