[乙状窦前联合幕上下入路的临床应用]。

PubMed ID
发表日期 2004年Apr月

原始出处 临床耳鼻咽喉科杂志
Lin chuang er bi yan hou ke za zhi = Journal of clinical otorhinolaryngology
作者 Li  Yongtuan  Chen  Ying  Xu  Shujun  Rong  Baogang  Ding  Yuanping  Zhang  Hanbing 

文献标题 [乙状窦前联合幕上下入路的临床应用]。
[Clinical application of the combined presigmoid supra-infratentorial approach].

文献摘要 OBJECTIVE

探讨桥小脑角及岩斜区病变的手术入路。

METHOD

采用乙状窦前幕下联合入路治疗桥小脑角或岩斜区大肿瘤9例,脑后血栓性动脉瘤1例。肿瘤包括3例神经鞘瘤和6例脑膜瘤。

RESULT

肿瘤全切除6例,次全切除4例。术后发生颅内感染后脑脊液漏1例,失访。9例头痛、头晕症状缓解。4例术前面瘫患者中,1例术后好转,3例术后无好转。3例小脑症状明显缓解,但大部分涉及其他颅神经的缺损术前均未恢复。根据Samii预后标准,7例预后良好,1例预后一般,1例预后差。5例听力无影响,2例听力下降20db,1例听力下降30db,1例听力下降60db。

CONCLUSION

乙状窦前-幕上-幕下联合入路直接入路至岩斜区和桥小脑角,手术范围广,小脑或脑回缩少,有利于切除病变,保留颅神经功能。


OBJECTIVE

To explore the surgical approach to the lesions of the cerebellopontine angle and the petroclival region.

METHOD

Nine cases of the cerebellopontine angle or petroclival large tumors and one case of the posterior cerebral thrombotic aneurysm were treated by the combined presigmoid supra-infratentorial approach. The tumors including 3 cases of schwannomas and 6 cases of meningiomas spaned supra-infratentorium in our study.

RESULT

Complete tumor removal were achieved in 6 cases, and subtotal tumor removal in 4 cases. After the operation, Cerebrospinal fluid leakage followed intracranial infection occurred in 1 case which losing follow-up. Headache and dizziness relieved in the other 9 cases. One case improved and 3 cases with no improvement after surgery among the 4 preoperative facial paralysis patients. Three cases with cerebellar symptoms were much relieved, but most deficits involving other cranial nerves preoperation did not recover. According to Samii's prognosis standard, 7 cases with good results and 1 case with common and 1 case with bad had been achieved. The hearing level had no influence in 5 cases, declined 20 dB HL in 2 cases, 30 dB HL in 1 case and 60 dB HL, in I case.

CONCLUSION

The combined presigmoid supra-infratentorial approach is a direct route to the petroclival region and the cerebellopontine angle, provides a wide surgical field with less cerebellar or brain retraction, facilitates the removal of lesions and preserves the cranial nerves functions.