枕骨大孔区脑膜瘤显微外科手术治疗

Microneurosurgical treatment of the foramen magnum meningiomas

目的 采用显微外科技术切除枕大孔区脑膜瘤 ,重点分析手术入路及技巧。方法 总结天坛医院 1993年 5月至 1997年 3月采用显微外科技术切除 19例枕大孔区脑膜瘤的经验。结果 19例中 4例采用枕下中线入路 ,其余 15例均采用远外侧入路 ,全切除 16例 ,次全切除 3例 ,术后有 6例行暂时性气管切开 ,无手术死亡。结论 枕大孔区脑膜瘤手术切除虽然困难 ,危险性较大 ,但采用显微外科技术合理选择最佳手术入路 ,肿瘤全切率及颅神经保护率会明显提高 。

Objective To review the microsurgical techique and operative approach of the foramen magnum meningiomas. Methods 19 cases of meningiomas centered on the foramen magnum were treated and studied microneurosurgically at our department from 1993 to 1997. Results Surgical approaches were extreme lateral approach in 15 cases, and subocciptal approach in 4 cases. Total removal was achieved in 16 cases and subtotal removal in 3 cases. Postoperative tracheotomy was performed in 6 cases. There was no operative mortality. Conclusion Meningiomas of the foramen magnum is benign tumor. Although the surgery is difficult, total resection can be achieved in most cases with microneurosurgical technique, and operative result is satisfied.