海绵窦海绵状血管瘤切除术中动眼神经的保护

Protection of the oculomotor nerve in cavernous hemangioma resection in cavernous sinus

目的：探讨海绵窦海绵状血管瘤切除术中动眼神经保护的方法。方法：应用去颧弓颞下硬膜下入路对8例海绵窦海绵状血管瘤进行手术切除。术中电生理监测诱发复合肌肉动作电位,观察动眼神经保护情况。结果：8例患者中肿瘤全切6例,部分残留2例;肿瘤平均体积为（20.24±1.09）ml,其中体积最大（45.35±3.19）ml;8例患者的动眼神经均在术中得以确认和保护,电生理监测均可监测到诱发复合肌肉动作电位。结论：应用去颧弓颞下硬膜下入路沿平行动眼神经假设走行路线的下方约2~3 mm处切开海绵窦,能很好地保护动眼神经。

Objective： To explore the protection of the oculomotor nerve in cavernous hemangioma resection in cavernous sinus.Methods： The cavernous hemangioma of cavernous sinus in 8 patients were resected by the subtemporal approach and removal zygomatic arch. The evoked compound muscle action potentials were monitored during operation,the protection of oculomotor nerve was observed. Results： Six tumors were totally removed,2 tumors were subtotally removed. The average of tumor volume was（ 20. 24 ± 1. 09）ml,the maximum of tumor volume was（ 45. 35 ± 3. 19） ml. The oculomotor nerves in 8 paients were protected,the evoked compound muscle action potentials of whose could be monitored. Conclusions： The incision of cavernous sinus under 2 to 3 mm of oculomotor nerve by subtemporal approach and removal zygomatic arch can greatly protect the oculomotor nerve.