枕下乙状窦后入路在桥小脑角区脑膜瘤中的应用经验

The role of suboccipital retrosigmoid approach in surgical treatment of CPA meningiomas

目的探讨枕下乙状窦后入路在桥小脑角区脑膜瘤手术中的作用。方法通过对我院自2001年12月到2015年12月53例采用枕下乙状窦后入路的桥小脑角区脑膜瘤手术病例进行分析,总结分析肿瘤的影像学特点、临床症状、手术疗效及术后神经功能。结果该组病例肿瘤全切48例,次全切除5例。术后症状和体征完全消失32例,症状较术前减轻7例,颅神经损害症状同术前3例,出现新神经功能障11例。结论枕下乙状窦后入路是处理桥小脑角区病变的经典手术入路,该入路可以获得对桥小脑区神经血管良好的暴露,手术创伤小,患者恢复快,术后并发症少。

Objective To discuss the role of suboccipital retrosigmoid approach in surgical treatment of cerebellopontine angle(CPA)meningiomas.Methods We reviewed the cases with the CPA meningiomas in our hospital from January 2004 to December 2015.A total of 53 patients underwent microsurgery through suboccipital retrosigmoid approach for CAP meningiomas and their clinical data were analyzed retrospectively including surgical approaches,efficacy and complications.Results In these 53 cases,tumor was completely resected in 48,subtotal removed in the other 5.All patients were followed up for 30 months to 8 years after the operation,in whom the preoperative symptom and sign disappeared in 32 patients,relieved in 7.The cranial nerve deficit was unchanged in 3 and new neurological deficit was present in 11.Conclusion Suboccipital retrosigmoid approach is a classic approach for the CPA lesions.It offers an excellent exposure to CPA region.