摘要
目的：试图通过改进手术入路而改善巨大岩斜脑膜瘤的手术治疗结果。方法：采用经颞下－乙状窦前入路切除５例巨大岩斜脑膜瘤。结果：全切除３例，２例恢复良好，另１例遗留对侧偏瘫和同侧Ⅲ、Ⅴ、Ⅵ脑神经功能障碍；次全切除的１例遗留持久性动眼神经瘫痪；而部分切除的１例则长期昏迷伴对侧偏瘫。结论：此入路的优点有：（１）到达岩斜区最直接，路径最短；（２）手术野开阔，显露良好；（３）可多视角操作；（４）只需很轻的脑牵拉。肿瘤不能全切除和出现严重并发症的主要原因是肿瘤包裹了基底动脉及其分支以及肿瘤破坏了软脑膜使肿瘤与脑干间失去界面。术前的ＭＲＩ检查有助于了解肿瘤侵犯脑干的程度和动脉包裹的情况。
Objective:To try to improve the outcome of giant petroclival meningiomas by way of using a new surgical approachMethod:5 patients with giant petroclival meningiomas were operated upon with subtemporalpresigmoidal approachResults:Of 3 cases with total removal,2 had good recovery;another one had hemiparesis and multiple cranial nerve palsiesPermanent oculomotor nerve palsy was resulted in the case with subtotal removal and prolonged coma and contralateral hemiparesis existed in the case with partial removalConclusions:The advantages of subtemporalpresigmoidal approach include:(1)direct approach with a short distance;(2)a wide surgical field;(3)multiple visualized angles between the subtemporal and presigmoidal route;(4)minimal brain retractionThe main influential factors on surgical results were whether presence of encasement of the basilar artery and its branches and of the arachnoidal cleavage plane between the tumor and the brain stemPreoperative MRI examination is very helpful to evaluate the arterial encasement and the invaded extent of the brain stem
出处
《中华显微外科杂志》
CSCD
北大核心
1998年第3期166-168,共3页
Chinese Journal of Microsurgery
