脑桥小脑角区手术损伤岩静脉安全性探讨

Safety of petrosal vein sacrifice during cerebellopontine angle surgery

岩静脉是后颅窝重要引流静脉,同时也是脑桥小脑角区手术需谨慎处理的重要解剖结构。术中损伤岩静脉对手术安全性的影响是持续争论且值得探讨的话题,一种观点认为术中损伤岩静脉是安全的,另一种观点则认为术中损伤岩静脉可引起术中或术后致死性并发症。本文拟就岩静脉解剖、岩静脉损伤相关并发症、损伤岩静脉的安全性争议、术前和术中岩静脉损伤相关并发症的预测进行综述,以促使神经外科医师重视术中岩静脉的处理方式。

Petrosal vein(PV)is an important drainage vein of posterior cranial fossa,needs to be properly preserved during cerebellopontine angle(CPA)surgery.Whether it is safe to sacrifice PV is a topic of intense debate and worth discussing.On one hand,some systematic studies concluded that the complications after obliteration of PV were negligible,and on the other hand,fatal complications caused by the sacrifice of PV were reported intermittently.This paper intends to review the anatomy of PV,the complications after sacrifice of PV,the evidence and opinions on the safety of PV sacrifice,and preoperative or intraoperative methods for evaluating the safety of PV sacrifice,so as to refine the surgical management of PV by neurosurgeons.