小脑桥脑角脑膜瘤的显微外科手术治疗

Microneurosurgical treatment of cerebellopontine angle meningiomas

目的 分析总结小脑桥脑角脑膜瘤的临床特点,探讨利用显微外科技术切除肿瘤的经验和技巧,以提高手术的全切率和面听神经保留率,预防并发症和降低死亡率。方法 对我科近10年经显微手术治疗的30例小脑桥脑角脑膜瘤进行回顾性分析研究。结果 本组肿瘤全切率为96.7％。面神经解剖保留率96.7％,位听神经解剖保留率80％。复发2例。本组无死亡。结论 显微外科手术治疗小脑桥脑角脑膜瘤是安全和有效的方法,熟练的手术技巧和手术前后的处理是保留面神经功能及降低死亡率的关键。

Objective To summarize the clinical characteristics and surgical results of cerebellopontine angle meningiomas (CPAM), and to discuss microneurosurgical technique and skill in operation procedure in order to improve the tumor total resection rate and facial-vestibulocochlear nerve bundle preservation rate, and to reduce the mortality and morbility. Methods Thirty cases of CPAM treated microsurgically in our department in the last 10 years were analyzed retrospectively. Results Total resection of CPAM was achieved in 96.1% of the patients. The facial nerve was anatomically preserved in 96. 7% of all cases. The vestibulocochlear nerve was anatomically preserved in 80% of the cases. No patient died, two patients recurred. Conclusion Microsurgery is a safe and effective method for treatment of CAPM. Surgical skill and peri-operative management are the key points to improve the surgical result.