神经内镜在显微神经外科桥小脑角区胆脂瘤术中的应用

Neuroendoscopy-assisted microneurosurgery for cerebellopontine angle cholesteatoma

选择2013年1月至2021年1月就诊于徐州医科大学附属医院,临床诊断为桥小脑角区胆脂瘤患者49例。所有患者均在术前进行MRI扫描评估,经乙状窦后入路显微镜下行肿瘤切除术,然后在0°和30°硬性神经内镜辅助下寻找残余肿瘤,继续切除肿瘤。38例常规显微手术后,在神经内镜下发现残留肿瘤并在神经内镜下切除。全切除44例,次全切除5例。术后并发症包括无菌性脑膜炎(8例)、脑脊液漏(1例)和颅内血肿(2例)。所有患者均获得随访,随访时间6~72(42±3)个月,无手术死亡病例。术后随访45例(91.8%)患者卡氏功能状态(KPS)评分≥80分。神经内镜辅助显微手术切除桥小脑角胆脂瘤,可提高全切除率,降低手术风险。

A total of 49 patients with cerebellopontine angle cholesteatoma from the Department of Neurosurgery,Affiliated Hospital of Xuzhou Medical University between January 2013 and January 2021 were recruited.All patients were evaluated by MRI scan before surgery and tumor resection was performed under microscope via retrosigmoid sinus approach.Then residual tumor was searched with 0°and 30°neuroendoscopy,and tumor resection was performed.Residual tumors were foundand resectedin 38 cases under theneuroendoscopy after routine microsurgery.Total and subtotalresections were performed in 44 cases and 5 cases,respectively.Complications included aseptic meningitis(n=8),cerebrospinal fluid leakage(n=1)and intracranial hematoma(n=2).Follow-up[42±3(6-72)months]was available in all patients.During follow-up,45 cases(91.8%)had a Kar-nofsky Performance Status(KPS)score≥80.Neuroendoscopy-assisted microsurgery for cerebellopontine angle cholesteatomas helps enhance the total resection rate and decrease the operative risk.