摘要
目的探讨如何根据岩斜区脑膜瘤颅底侵袭部位合理设计手术计划，提高疗效。方法回顾性分析59例岩斜区脑膜瘤患者手术治疗的临床资料，统计岩斜区脑膜瘤颅底侵袭部位的分布和特点，分析其与手术入路选择的关系及对肿瘤切除程度的影响。结果59例中侵袭上岩斜区（A区）51例（86％），侵袭中岩斜区（B区）45例（76％），侵袭下岩斜区（C区）13例（22％），侵袭桥小脑角区（D区）19例（32％），侵袭鞍旁海绵窦区（E区）28例（47％）。59例中仅累及单个分布区的占12％，2个分布区的占36％，3个分布区的占31％，4个分布区的占14％，5个分布区的占8％。行眶颧入路2例，颞下入路7例，乙状寞后入路14例．乙状窦前入路33例，乙状窦后入路＋远外侧入路3例。根治性切除23例，次全切除26例，大部分切除10例。结论根据岩斜区脑膜瘤颅底侵袭区域特点合理选择手术入路可以提高手术疗效。
Objective To make a suitable surgical plan according to the sites invaded by petroclival meningionmas of skull base so as to improve the therapeutic effect. Methods We retrospectively reviewed the data of 59 cases of meningiomas in petroclival region and statistically analyzed the distribution and other features of the invasion site of petroclival meningiomas to determine their relationships with the surgical approach and their effects on degree of the tumor resection. Results In all of the 59 cases, 51 （86%）, 45 （76%）, 13 （22%）, 19 （32%） and 28 （47%） involved in the invasion of superior petroclival region （region A）, of middle petroclival region （region B）, of inferior petroclival region （region C）, of cerebellopontine angle region （region D） and of parasella cavernous sinus region （region E）, respectively. The cases involved in 1, 2, 3, 4 and 5 distribution regions accounted for 12%, 36%, 31%, 14% and 8%, respectively. Orbitozygomatic approach was performed in 2, subtemporal approach in 7, retrosigmoid approach in 14, presigmoid approach in 33, and retrosigmoid approach plus far lateral approach in 3. Of the 59 cases, 23, 26 and 10 had been given gross total resection, near total resection and subtotal resection, respectively. Conclusion Surgical effects can be improved by choosing a suitable operative approach according to the characteristics of the division of petroclival meningioma invasion towards skull basis.
出处
《中华神经医学杂志》
CAS
CSCD
北大核心
2009年第12期1252-1254,共3页
Chinese Journal of Neuromedicine
关键词
岩斜区
脑膜瘤
显微外科手术
Petroclival region
Meningioma
Microsurgery
