颞下经天幕入路显微手术治疗岩斜区脑膜瘤

Microsurgical treatment of petroclival meningiomas through subtemporal transtentorial approach

目的：探讨颞下经小脑幕入路切除岩斜区脑膜瘤的显微手术方法和结果。方法25例岩斜区脑膜瘤病人，全部经CT、MRI明确诊断，其中大型（瘤径2．5-4．4 cm）18例、巨大型（＞4．5 cm）7例。均采用颞下经小脑幕入路显微手术切除肿瘤。结果镜下全切除肿瘤20例（80％），大部分切除5例，无死亡。术后新增颅神经损伤11例。术后随访1-24个月，全切病例有4例复发。结论颞下经小脑幕入路是切除中上斜坡以上尤其是侵及麦氏腔的岩斜区脑膜瘤实用的手术入路。

Objective To explore the microsurgical treatment methods and results of petroclival meningiomas through subtemporal transtentorial approach .Methods 25 patients with petroclival meningiomas were performed microsurgery through subtemporal transtentorial approach .CT and MRI showed the tumor diameter were between 2.5-4.4 cm in 18 cases,〉4.5 cm in 7 cases.Results 20 cases of tumors were totally removed ,5 partial removed , no operative death .11 cases had new crainal never deficits after operation .There were 4 cases recurrence during 1 -24 monthes following up . Conclusion Subtemporal transtentorial approach is a practical method for microsurgery of petroclival meningiomas occupied the upper slope ,especially invased the Meckel cavity .