岩斜区脑膜瘤显微外科治疗

Microsurgical treatment of petroclival meningiomas

目的探讨岩斜区脑膜瘤的显微手术治疗方式及疗效。方法回顾性分析2012年1月～2015年12月采取不同手术入路治疗的66例岩斜区脑膜瘤的临床、影像、手术及随访资料。结果肿瘤全切46例（Simp—sonI—III级），次全切20例（SimpsonIV级）。1例患者术后死于颅内感染，25例患者术后出现新的神经功能障碍，其中19例在末次随访过程中明显改善或消失。结论手术治疗目标是最大限度的切除肿瘤并减少术后并发症，针对累及不同区域的肿瘤选择不同入路，实现岩斜区脑膜瘤的个体化治疗，有助于疗效的提高。

Objective To investigate the microsurgical treatment and curative effect of petroclival meningiomas. Methods Clinical, surgical and imaging data of 66 patients who underwent surgical removal of petroclival meningiomas via different approaches in our department from Jan 2012 to Dec 2015 were analyzed retrospectively and the follow-up results were evaluated. Results According to the Simpson classification, total tumor resection （ Grade I-III） was achieved in 46 cases, subtotal resection （Grade IV） in 20 cases. One patient died of postoperative intracranial infection. New postoperative neurological deficits occurred in 25 cases, while they were transient in 19 cases. Conclusions The aim of operation is maximal resection of the tumors with minimal complications. Different approaches should be used according to the areas encroached by tumors to achieve individualized treatment and contribute to the improvement of therapeutic efficacy for petroclival meningiomas.