显微手术切除岩斜区巨大脑膜瘤的策略和技巧

Microsurgical strategy and technique for large petroclival meningiomas

目的探讨显微手术切除岩斜区巨大脑膜瘤的策略和技巧。方法总结35例岩骨尖斜坡区巨大脑膜瘤的临床表现、显微手术方法、手术结果和术后处理。结果肿瘤全切除21例(60%),死亡2例(5.7%)。其中经岩骨乙状窦前幕上下联合入路22例,全切除18例(82%),无死亡。结论根据术前与术中的策略,选择好手术入路和运用好显微外科技术可以提高岩骨尖斜坡区巨大脑膜瘤的切除率,降低手术病死率。

Objective The aim of this retrospective study is to discuss the microsurgical strategy and technique for large petroclival meningiomas by evaluating the results of surgery in 35 cases. Methods The clinical manifestation, operative approaches, results of surgery and postoperative management of petroclival meningioma were discussed. Results Total tumor removal was achieved in 21 cases (60%) with death of 2 cases; 22 cases were undergone surgery by a combined presigmoid retrolabyrinthine approach with 18 cases(82%) of total tumor removal. There was no mortality in these cases. Conclusion Careful consideration before surgery, choosing a proper approach and good microneurosurgical skills can increase the percentage of total tumor removal and decrease the mortality in the surgical management of large petroclival meningiomas.