神经内镜经颞下硬膜外锁孔入路治疗颅中窝肿瘤

Surgical treatment of middle cranial fossa tumors by endoscopic epidural subtemporal keyhole approach

目的总结经颞下硬膜外神经内镜锁孔入路手术切除颅中窝肿瘤的手术经验。方法回顾性分析5例颅中窝肿瘤的病例资料,均采用颞下硬膜外锁孔入路,在单纯内镜下切除肿瘤。结果肿瘤全切除4例,次全切除1例。术后病理为神经鞘瘤、间变型脑膜瘤、脊索样型脑膜瘤、脊索瘤和胆脂瘤。1例出现脑水肿,经甘露醇治疗后缓解。随访2~6个月,4例全切肿瘤无复发,1例脊索瘤稍进展行上颌部肿瘤切除术。结论经颞下硬膜外神经内镜锁孔入路手术切除颅中窝肿瘤,手术创伤小、术后并发症少,是切除颅中窝肿瘤安全有效的术式。

Objective To study the surgical experience of subtemporal epidural neuroendoscopic keyhole approach for resection of middle cranial fossa tumors.Methods The clinical data of 5 patients with middle cranial fossa tumors,which were resected by neuroendoscopy alone via subtemporal extradural keyhole approach,were analyzed retrospectively.Results Total tumor resection was achieved in 4 cases and subtotal resection in 1.Postoperative pathologic diagnosis was schwannoma,anaplastic meningioma,chordoid meningioma,chordoma and cholesteatoma respectively.One case of cerebral edema was relieved after mannitol treatment.During 2 to 6 months of follow-up,4 cases of total tumor resection had no recurrence,and 1 case of chordoma progressed slightly to perform maxillary tumor resection.Conclusions Surgical removal of tumors in the middle skull base via neuroendoscopic epidural subtemporal keyhole approach would cause only less surgical trauma and fewer postoperative complications.It is a safe and effective procedure for the removal of tumors in the middle cranial fossa.