翼点keyhole入路处理前循环及鞍周部位病变

Sidebums mini-incision pterion keyhole craniotomy to lesions of the a nterior circulation and peri-sellar region

目的介绍颞部鬓角皮肤小切口,翼点keyhole骨孔(2.5cm×3cm)入路处理前循环动脉瘤、前颅窝底及鞍周部位病变。方法病人仰卧、面转向对侧60°。沿鬓角的发际前缘做一皮肤切口,长约6～7cm。从额骨颧突下剥离颞肌,显露出翼点。颅骨钻孔后直接用咬骨钳咬成3cm×3cm骨孔。2∶3显露额颞叶,切开硬脑膜,分离外侧裂,进入手术区。结果采用此keyhole开颅术进行各类手术52例,手术进行顺利。结论翼点keyhole开颅术具有对外观影响小,开关颅时间短(15～20min),创伤轻微等优点。

Objective To introduce a sidebums mini-incision pterion keyhole appro ach to lesions of the anterior circulation and perisellar region. Methods The patients were placed supine position with the head maintained at 60 degrees rota tion. A 6~7 cm skin incision was made at the anterior border of the sidebums. Te mporal muscle was stripped from frontal bone zygomatic process and exposed pteri on. After the skull was bore, A 3 cm×3 cm keyhole was made by a bone rongeur an d the lateral sphenoid wing was grinded out. Frontal lobe was exposed 2/3 and te mporal lobe was exposed 1/3 in this keyhole, dissociated lateral fissure and ent ered operative area. Results Fifty-two cases were performed through this appro ach. Conclusion This sidebums mini-incision pterion keyhole craniotomy techniqu e shortened the time of open-close cranium and reduced surgery-related traumatiz ation to patients. The cosmetic results were favorable.