经颞下锁孔入路切除岩尖部肿瘤手术的疗效分析

Subtemporal keyhole approach for petrous apex tumors

目的分析颞下锁孔入路切除岩尖部肿瘤手术的疗效及优点。方法回顾性分析2018年10月—2019年6月9例行经颞下锁孔入路岩尖部肿瘤切除手术患者的临床资料。结果9例患者中包括脑膜瘤5例、神经鞘瘤4例,肿瘤均做到全切除;术后影像学复查未见明显肿瘤残留。术后3例患者出现切口局部皮下积液,出院前恢复良好;所有患者均未出现明显的面瘫、眼球活动障碍、脑脊液漏、切口感染、癫痫、失语等并发症。患者术后随访2~10个月,未见明显肿瘤残留及症状复发。结论经颞下锁孔入路对于岩尖部肿瘤的切除能提供充分的暴露,在满足手术需要的同时,具有创伤小、术后恢复快、并发症少的优点。

Objective To summarize the methods and experiences of petrous apex tumors removal by subtemporal keyhole approach.Methods The clinical data of 9 patients underwent tumors resection through subtemporal keyhole approach from October 2018 to June 2019 were analyzed retrospectively.Results Total resection was done in all 9 patients including 5 meningioma and 4 schwannoma.Postoperative MRI showed no residual tumor in all cases.Subcutaneous hydrops occurred in 3 cases and were all recovered before discharge.Postoperative complications including facial palsy,eye movement disorder,cerebrospinal fluid leak,infection,aphasia or seizure were not found.All patients were followed up from 2 to 10 months and no recurrent case was found.Conclusion Subtemporal keyhole approach provides sufficient exposure for petrous apex tumors while has advantages of less injury,faster recovery and less complications.