岩斜区肿瘤显微外科治疗手术入路选择(附17例报告)

Microsurgical Treatment of Petroclival Tumor(Report of 17 Cases)

目的 :探讨岩斜区肿瘤外科治疗手术入路选择。方法 :回顾性分析我院自 1997年至 2 0 0 0年 6月显微外科手术治疗的 17例岩斜区肿瘤。 12例肿瘤直径大于 4cm。采用 6种手术入路 :颞下 -小脑幕 ;天幕上下联合 ;颞下 -乙状窦前 ;枕下乳突后 ;枕下远外侧 ;额眶颧入路。结果 :肿瘤全切除 12例 (71% ) ,术后恢复良好者 11例 (6 5 % ) ,术后新增颅神经损害 6例 (35 % )。结论 :选择和掌握适合的颅底手术入路 ,采用显微外科技术切除岩斜区肿瘤可取得满意效果。

Objective:To evaluate the advantages of choosing diverse surgical approaches for petroclival tumor.Methods:Seventeen cases with petroclival tumor treated under microsurgery were studied retrospectively.Twelve lesions were larger than 4cm in their largest diameter.According to the location of petroclival tumor,the following 6 approaches could be flexibly chosen and individually used:Subtemporal-transtentorial:Subtemporal-presigmoid;Suboccipital-retromastoid;Suboccipital-far lateral;Combined supra-and infratentorial;Frontoorbitozygomatic approaches.Results:Total removal of the tumor was achieved in 12 patients, favourable postoperative results showed in 11 cases and new postoperative injuries of cranial nerves occurred in 6 cases.Conclusion:The satisfactory outcome could be resulted by properly selecting and skillfully comprehending the operative approaches to cranial base lesions and by adopting the advanced microsurgical techniques.