Objective To discuss the operative technique of parapetrosal presigmoid approach for patients with petroclival tumors and its outcome. Methods 16 petroclival tumors have been microsurgical treated with parapetrosal pr...Objective To discuss the operative technique of parapetrosal presigmoid approach for patients with petroclival tumors and its outcome. Methods 16 petroclival tumors have been microsurgical treated with parapetrosal presigmoid approach and the clinical data were analysed retrospectively. Results In all patients, 9 had meningiomas, 3 epidermoid cysts, 2 pontine gliomas, and 2 schwannomas. Total resection was performed in 12 patients, subtotal resection in 3, and near subtotal resection in 1. Temporary post-operative cranial nerve paresis occurred in 3 patients but no CSF leakage and mortality ever occurred. Conclusion This approach is simpler and safer than other more extensive transpetrosal approaches. It can expose sufficiently the petroclival regions and facilitate tumor removal and provides good clinical outcome.展开更多
Background： During craniotomies using the transpetrosal-presigmoid approach, exposure of the sigmoid sinus remains an essential but hazardous step. In such procedures, accurate localization of the anterosuperior poin...Background： During craniotomies using the transpetrosal-presigmoid approach, exposure of the sigmoid sinus remains an essential but hazardous step. In such procedures, accurate localization of the anterosuperior point of the transverse-sigmoid sinus junction （ASTS） is very important lbr reducing surgical morbidity. This study aimed to create an accurate and practical method for identifying the ASTS. Methods： On the lateral surfaces of 40 adult skulls （ 19 male skulls and 21 female skulls）, a rectangular coordinate system was defined to measure the x and y coordinates of two points： the ASTS and the squamosal-parietomastoid suture junction （SP）. With the coordinate system, the distribution characteristics of the ASTS were statistically analyzed and the differences between the ASTS and SP were investigated. Results： For ASTS-x, significant differences were found in different sides （P =0.020）; the ASTS-x in male skulls was significantly higher on the right side （P =0.017）; there was no significant difference between the sides in female skulls. There were no significant differences in gender or interaction of gender and side for ASTS-x, and for ASTS-y, there were no significant differences in side, gender, or interaction of gender and side. For both sides combined, the mean ASTS-x was significantly higher than the mean SP-x （P = 0.003） and the mean ASTS-y was significantly higher than the mean SP-y （P = 0.011 ）. Conclusions： This reference coordinate system may be an accurate and practical method for identifying the ASTS during presigmoid craniotomy. The SP might be difficult to find during presigmoid craniotomy and, therefore, it is not always a reliable landmark for defining the ASTS.展开更多
目的:为临床乙状窦前入路手术提供岩静脉的解剖学资料。方法:15例30侧福尔马林固定国人成人尸头,模拟乙状窦前入路操作,内窥镜下观察岩静脉的主干、属支分布,与周围结构的关系。而后开颅取出脑组织,显微镜下观察、测量岩静脉主干直径的...目的:为临床乙状窦前入路手术提供岩静脉的解剖学资料。方法:15例30侧福尔马林固定国人成人尸头,模拟乙状窦前入路操作,内窥镜下观察岩静脉的主干、属支分布,与周围结构的关系。而后开颅取出脑组织,显微镜下观察、测量岩静脉主干直径的大小、进入岩上窦的位置,其属支分布的区域和供血的范围。结果:(1)岩静脉主干直径为(4.02±1.24)m m(1.18～6.38 m m)。其进入岩上窦的位置距离M eckel's囊口后缘、内耳门后缘中点、岩上窦-乙状窦交点的距离分别为:(9.46±3.68)m m(3.10～17.52 m m)、(9.40±1.65)m m(6.64～13.82 m m)、(27.42±3.75)m m(18.20～36.56 m m)。(2)岩上静脉引流脑桥、延髓腹侧,小脑岩骨面、小脑背外侧的静脉回流血,内窥镜可以明确岩静脉的主干周围结构的毗邻关系。结论:内窥镜的应用可为手术中岩静脉的辨认和保护提供准确的信息,有助于避免不必要的损伤。展开更多
文摘Objective To discuss the operative technique of parapetrosal presigmoid approach for patients with petroclival tumors and its outcome. Methods 16 petroclival tumors have been microsurgical treated with parapetrosal presigmoid approach and the clinical data were analysed retrospectively. Results In all patients, 9 had meningiomas, 3 epidermoid cysts, 2 pontine gliomas, and 2 schwannomas. Total resection was performed in 12 patients, subtotal resection in 3, and near subtotal resection in 1. Temporary post-operative cranial nerve paresis occurred in 3 patients but no CSF leakage and mortality ever occurred. Conclusion This approach is simpler and safer than other more extensive transpetrosal approaches. It can expose sufficiently the petroclival regions and facilitate tumor removal and provides good clinical outcome.
文摘Background： During craniotomies using the transpetrosal-presigmoid approach, exposure of the sigmoid sinus remains an essential but hazardous step. In such procedures, accurate localization of the anterosuperior point of the transverse-sigmoid sinus junction （ASTS） is very important lbr reducing surgical morbidity. This study aimed to create an accurate and practical method for identifying the ASTS. Methods： On the lateral surfaces of 40 adult skulls （ 19 male skulls and 21 female skulls）, a rectangular coordinate system was defined to measure the x and y coordinates of two points： the ASTS and the squamosal-parietomastoid suture junction （SP）. With the coordinate system, the distribution characteristics of the ASTS were statistically analyzed and the differences between the ASTS and SP were investigated. Results： For ASTS-x, significant differences were found in different sides （P =0.020）; the ASTS-x in male skulls was significantly higher on the right side （P =0.017）; there was no significant difference between the sides in female skulls. There were no significant differences in gender or interaction of gender and side for ASTS-x, and for ASTS-y, there were no significant differences in side, gender, or interaction of gender and side. For both sides combined, the mean ASTS-x was significantly higher than the mean SP-x （P = 0.003） and the mean ASTS-y was significantly higher than the mean SP-y （P = 0.011 ）. Conclusions： This reference coordinate system may be an accurate and practical method for identifying the ASTS during presigmoid craniotomy. The SP might be difficult to find during presigmoid craniotomy and, therefore, it is not always a reliable landmark for defining the ASTS.
文摘目的:为临床乙状窦前入路手术提供岩静脉的解剖学资料。方法:15例30侧福尔马林固定国人成人尸头,模拟乙状窦前入路操作,内窥镜下观察岩静脉的主干、属支分布,与周围结构的关系。而后开颅取出脑组织,显微镜下观察、测量岩静脉主干直径的大小、进入岩上窦的位置,其属支分布的区域和供血的范围。结果:(1)岩静脉主干直径为(4.02±1.24)m m(1.18～6.38 m m)。其进入岩上窦的位置距离M eckel's囊口后缘、内耳门后缘中点、岩上窦-乙状窦交点的距离分别为:(9.46±3.68)m m(3.10～17.52 m m)、(9.40±1.65)m m(6.64～13.82 m m)、(27.42±3.75)m m(18.20～36.56 m m)。(2)岩上静脉引流脑桥、延髓腹侧,小脑岩骨面、小脑背外侧的静脉回流血,内窥镜可以明确岩静脉的主干周围结构的毗邻关系。结论:内窥镜的应用可为手术中岩静脉的辨认和保护提供准确的信息,有助于避免不必要的损伤。
