经岩周乙状窦前入路显微外科切除岩斜区肿瘤

Parapetrosal presigmoid approach for microsurgical removal of petroclival tumors

目的 探讨经岩周乙状窦前入路显微外科切除岩斜区肿瘤的疗效及手术技巧。方法采用Fukushima提出的经岩周乙状窦前入路显微外科切除岩斜区肿瘤16例并对其临床资料进行回顾性分析。结果 全组病例包括脑膜瘤9例,表皮样囊肿3例,桥脑胶质瘤2例,神经鞘瘤2例。获肿瘤全切除12例,次全切除3例,大部切除1例。术后新出现暂时性颅神经障碍3例,无脑脊液漏及死亡。结论 该入路较其它扩大经岩乙状窦前入路更简便、安全,可充分显露岩斜区,有利于提高肿瘤切除程度和术后疗效,是岩斜区肿瘤手术治疗的较佳入路。

Objective To discuss the surgical outcome and operative technique in patients with petroclival tumors treated by parapetrosal presigmoid approach. Methods 16 petroclival tumors have been treated microsurgically by parapetrosal presigmoid approach developed by Fukushima. The clinical data have been analysed retrospectively. Results In our series, there were 9 meningiomas, 3 epidermoid cysts, 2 pontine gliomas, and 2 schwannomas. Total resection was performed in 12 patients, subtotal resection in 3, and partial resection in 1. Transient cranial nerve paresis occurred newly in 3 patients postoperatively. NO CSF leak and death occurred. Conclusions This approach is simpler and safer than other extensive petrosal approaches. It can expose sufficiently the petroclival regions and raise the removal degree and curative effect. So it is suitable for surgical treatment of petroclival tumors.