经额颞颧-硬膜外入路切除海绵窦区三叉神经鞘瘤

Surgical treatment of intracavernous trigeminal schwannoma via frontotemporal epidural approach

目的探讨海绵窦区三叉神经鞘瘤的手术入路及其治疗效果。方法回顾性分析经额颞颧-硬膜外入路切除7例海绵窦区三叉神经鞘瘤病人的临床资料、影像学表现及其术后疗效。结果肿瘤全切除7例,均经病理证实为三叉神经鞘瘤。术后出现不同程度面部感觉减退、咀嚼无力等三叉神经损伤症状。随访48~60个月,平均54个月,无肿瘤复发,7例病人恢复正常生活和工作。结论额颞颧-硬膜外入路适用于海绵窦区三叉神经鞘瘤,可保护周围重要神经、血管,具有损伤小、术后并发症少等手术特点。

Objective To explore the surgical approach and surgical outcomes of intracavernous trigeminal schwannoma（ITS）.Methods Clinical data,imaging findings and surgical outcomes of 7 ITS patients via frontotemporal epidural approach were analyzed retrospectively.Results Total tumor resection was achieved in all the 7 patients,and the tumors were confirmed as ITS by pathology.Facial sensory loss to varying degree,chewing weakness and other symptoms of trigeminal nerve injury occurred after the operation.Seven patients were followed up for a mean period of 54 months,ranging from 48 to 60 months,no tumor recurred and all of them returned to normal life and work.Conclusion Tumor resection via frontotemporal epidural approach can protect the surrounding nerves and blood vessels,characterized by less damage,less postoperative complications and other surgical features,thus being suitable for ITS.