神经内镜辅助显微手术切除颅内广泛复杂表皮样囊肿

Neuroendoscope-assisted microsurgery for the removal of intracranial extensive complex epidermoid cysts

目的探讨神经内镜辅助显微手术切除颅内广泛复杂表皮样囊肿的应用价值。方法回顾性分析16例颅内广泛复杂表皮样囊肿的病例资料,应用神经内镜辅助显微手术切除病变,其中枕下乙状窦后入路13例,颞下经小脑幕入路2例,枕下后正中入路1例。结果全部病例在显微手术切除后神经内镜下仍发现有残瘤,残瘤率100%,再行神经内镜下切除残瘤。全切除15例,全切率93.8%;大部分切除1例(病灶广泛无法从单一手术入路切除)。术后病人临床症状均得到不同程度缓解,无新增神经功能障碍与死亡病例,全切病例随访1年无复发。结论神经内镜辅助显微手术切除颅内广泛复杂表皮样囊肿具有独特优势,可提高肿瘤全切率,减少手术并发症。

Objective To explore the application value of neuroendoscopy-assisted microneurosurgery(NEAM)in the resection of intracranial extensive complex epidermoid cysts.Methods The clinical data of 16 patients with intracranial extensive complex epidermoid cysts treated by NEAM,including 13 whose cysts were resected via suboccipital retrosigmoid approach,2 via the subtemporal transtentorial approach,1 case of suboccipital midline approach,were analyzed retrospectively.Results In all the patients,residual tumors were still observed under neuroendoscope after microsurgery,and the residual tumor rate was 100%.Then the residual tumor resection was performed under neuroendoscope.Total tumor resection was achieved in 15 cases,with a total resection rate of 93.8%;and partial resection in 1,whose extensive lesions could not be removed from a single surgical approach.The clinical symptoms of these patients after surgery were all relieved to varying degrees.There were no new cases of neurological dysfunction and death.The patients with total resection were followed up for 1 year without recurrence.Conclusions NEAM has a unique advantage in the resection of intracranial extensive complex epidermoid cysts,can improve the total tumor resection rate and reduce surgical complications.