神经内镜辅助的中后颅窝胆脂瘤显微手术治疗

Neuroendoscope-assisted microsurgery of middle and posterior fossa cholesteatoma

目的 探讨神经内镜辅助的中后颅窝胆脂瘤手术治疗效果及技巧。方法 根据瘤体部位分别采用颞下入路和枕下乙状窦后入路,在神经内镜的辅助下,对同时跨越中后颅窝的15例胆脂瘤施行手术治疗。结果瘤体全切率100%;颞下入路1例术后出现滑车神经受损表现,1例动眼神经不完全性麻痹;枕下入路中1例因脑干水肿而昏迷,轻度面瘫1例;无死亡及无菌性脑膜炎病例。结论 在神经内镜辅助下,中后颅窝胆脂瘤的显微手术可增加全切率,减少对脑干、各脑神经的牵拉和重要血管的损伤,使手术更加安全、有效。

ve To investigate the curative effects and operative techniques for surgical treatment of middle and posterior fossa epidermoid cysts assisted by neuroendoscope. Methods Subtemporal and suboccipital approaches were selected according to the main location of the tumor. Microsurgical resection assisted by neuroendoscope was applied in 15 patients with middle and posterior fossa epidermoid cysts. Results All tumors were totally resected; transient disfunction of the trochlear nerve, oculomotor nerve and facial nerve respectively happened in 3 cases, and 1 patient had coma. Conclusion Microsurgical treatment assisted with neuroendoscope may increase the total resection rate, decrease retraction to the brainstem, nerves, and vessel damage. It is safe and effective.