经颞下小脑幕入路手术治疗中后颅窝三叉神经鞘瘤七例

Effect of Temporomandibular Tentorium Cerebelli Approach in Surgical Treatment of Trigeminal Neurinomas of Middle and Posterior Fossae

目的观察经颞下小脑幕入路手术治疗骑跨中后颅窝的哑铃状三叉神经鞘瘤的效果。方法对我院2008年10月～2010年6月经颞下小脑幕入路行肿瘤切除的骑跨中后颅窝的哑铃状三叉神经鞘瘤7例的临床资料进行回顾性分析。结果本组肿瘤全部切除,手术全切除率100%。术后出现及原有颅神经功能障碍3例,其中面部麻木2例,复视1例。7例随访3～18个月,平均8.4个月,生活能自理,可从事轻体力劳动。术后6个月复查MRI均未发现肿瘤复发。结论经颞下小脑幕入路手术治疗骑跨中后颅窝的哑铃状三叉神经鞘瘤操作简单、省时,且显露效果满意,有较大的操作空间,可最大限度地减少脑组织及神经、血管的损伤。

Objective To investigate the effect of temporomandibular tentorium cerebelli approach in surgical treatment of trigeminal neurinomas of middle and posterior fossae.Methods 7 patients with dumbbell-shaped trigeminal neurinomas of middle and posterior fossae,admitted into our hospital during October 2008 to June 2010 underwent temporomandibular tentorium cerebelli approach in surgical treatment and their clinical data were retrospectively analyzed.Results All trigeminal neurinomas were resected(100%).3 patients had postoperational neurological deficits,among whom,2 had facial numbness and one had diplopia.7 patients were followed up for 3 to 18 months,with 8.4 months on an average.They were able to manage self-care,and do light physical work.No tumor recurrences were found six months after surgery via MRI.Conclusion Temporomandibular tentorium cerebelli approach for dumbbell-shaped trigeminal neurinomas of middle and posterior fossae is a feasible and applicable method.The procedure is easy to peform,takes less time with better exposuriment and larger operation interspace,and can reduce the injury of brain tissue,nerve,and blood vessels.