神经内镜辅助技术在显微手术切除桥小脑角区表皮样囊肿中的应用

Application of the endoscope-assisted microsurgical operation technique to resect cerebellopontine angle epidermoid cyst

目的探讨显微手术切除桥小脑角区表皮样囊肿中神经内镜辅助技术的应用价值。方法总结32例桥小脑角区胆脂瘤病例,分析手术技术特点和术中操作注意事项。结果神经内镜术中观察9例内容物术中全切,另外23例均有不同程度的肿瘤内容物残留。借助神经内镜辅助手术后肿瘤内容物残余病人中18例得到全切。10例患者术后小脑症状缓解,5例患者三叉神经痛及颜面部麻木症状缓解,听力下降病例3例好转,2例病人术后有面瘫,2例病人术后发热考虑为无菌性脑炎发生,经治疗痊愈,无死亡病例。结论神经内镜技术应用,在切除桥小脑角区胆脂瘤的过程中优势突出,其多角度的观察,利用自然缝隙间操作,可以全切肿瘤,降低术后并发症,提高患者术后生活质量。

Objective To explore the application value of endoscope-assisted microsurgical operation technique to resect cerebellopontine angle epidermoid cyst. Method To summarize 32 cholesteatoma cases in cerebellopontine angle and analyze the operation characteristics and intraoperative points to note. Results Of 32 cases, 9 cases contents total resection, the other 23 cases had different degrees of re- sidual tumor contents. With the help of endoscope- assisted operation, 18cases acquired total resection contents. Cerebellar symptoms re- lieved in 10 cases; trigeminal nerve pain and facial numbness symptoms relieved in 5 cases; hearing loss improved in 3 cases, facial pa- ralysis were found in 2 cases. 2 cases had a postoperative fever, which was caused in aseptic encephalitis and was cured;no death case. Conclusions The application of endoscopic technique acquire outstanding advantages in the removal of cerebellopontine angle chol- esteatoma, including the multi-angle observation, utilization of natural gap. It can help us to resect the tumor totally, reduce the postoper- ative complications, improve the quality of life of patients.