枕下极外侧入路切除颅颈交界区腹侧病变

Far lateral suboccipital approach for removing the anterior or anterolateral lesions in craniospinal junction

目的 探讨枕下极外侧入路切除颅颈交界区腹侧病变的效果 ,并对一些手术技巧加以改进和讨论。方法 采用枕下极外侧入路对 8例颅颈交界区腹侧及腹外侧病变进行手术治疗。结果 本组 8例病人 ,6例痊愈 ,2例好转。 7例肿瘤病人 ,5例肿瘤全切除 ,2例次全切除。全组无手术死亡。术后并发症 :面瘫 1例 ,后组脑神经轻度麻痹 1例 ,脑脊液漏 1例。结论 枕下极外侧入路可以满足颅颈交界区腹侧及腹外侧病变手术野的显露 。

Objective To explore the operative results of removing craniospinal junction lesions and to modify some operative techniques. Methods The far lateral suboccipital opproach was used in 8 patients with lesions of the anterior or anterolateral craniospinal junction. Results Curation in 6 patients and remission in 2 patients were obtained. Tumors were totally removed in 5 and nearly totally removed in 2 of the 7 tumor patients. No one died. Postopertive complication included nerve Ⅶ plasy in 1 patient, cranial nerve Ⅸ～Ⅻ paralysis in 1 patient and cerebrosrpinal fluid fistula in 1 patient. Conclusion The far lateral suboccipital approach may expose extensively the anterior and anterolaeral medula oblongata or upper cervical spine. It is an effective approach to remove lesion.