摘要
目的探讨斜坡、枕大孔区腹侧病变的手术方法和远外侧入路手术适应证。方法选择斜坡和枕大孔区腹侧病变２２例，其中脊索瘤１０例，脑膜瘤４例，舌下神经鞘瘤４例，椎－基底动脉汇合处动脉瘤２例，软骨肉瘤和纤维肉瘤各１例。３例肿瘤下极达颈２水平。依据需要磨除枕骨髁１／３或全部及其它骨块。２例侵入咽后壁的脊索瘤先经远外侧入路切除颅内部分肿瘤，再二期经口咽入路切除咽后壁部分。结果显微手术全切除１８例，次全切除２例，２例椎－基底动脉汇合处动脉瘤成功夹闭，术后均恢复良好。
Objective To study operating methods of lesions at clivus and ventral magnum disscuse foraman area, and to discuse the definition and indication of far lateral approach Methods Twenty two patients, 12 males and 10 females, age 12～54 years Chordoma 10, meningioma 4, subglossal neurilemoma 4, aneurysms in the bifurcation of vertibral and basilar artery 2, chondrosarcma and fibrosarcoma for 1 each Three cases of the lower end of the tumor extended to the level of C 2 Patients are in lateral position, sigmoid sinus was exposed during operation ,ligated and cut it when neccessary ,isolated the vertebral artery, burred off 1/3 or the whole occipital condylus and other bones according to the condition during operation Two cases of chordoma involved posterior wall of pharynge, intra skull part of the tumor in was removed the first phase trans far lateral approach, then removed the pharyngeal part trans oral pharyngeal approach in the second phase Results Eighteen cases were totally removed under microscope, 2 cases were subtotally removed, 2 cases of aneurysm were successfully clipped The effects of postoperation were well Conclusion Far lateral approach is preferable for treating lesions at clivus and ventral magnum foraman area
出处
《中华显微外科杂志》
CSCD
北大核心
1999年第2期93-94,共2页
Chinese Journal of Microsurgery
