颞下小脑幕入路切除中上岩斜区肿瘤

摘要

Objective To improve the therapeutic effect of the petroclival tumors removed via subtemporal transtentorial approach by microsurgical techniques.Methods Thirty-two patients with tumors in mid-superior petroclival region,admitted to our hospital from January 2005 to December 2011 and underwent microsurgery through subtemporal transtentorial approach.The clinical manifestations,surgical methods and treatment efficacy were retrospectively analyzed.Results Thirty-two patients with tumors included 20 meningiomas,7 neurilemmoma and 5 epidermoid cyst.Total resection was achieved in 22 cases,subtotal resection in 6 cases,and partial resection in 4 cases.Fifteen patients developed new postoperative neurological deficits.The patients were followed up for 3 to 12 months,and the neurological functions recovered in varying degrees.Conclusions The subtemporal transtentorial approach is one of the optimal approaches to remove the mid-superior petroclival tumors because of its mini-invasion and less complications,indicating for a wide application in clinic.%目的 探讨经颞下-小脑幕入路显微手术切除中上岩斜区肿瘤的方法和疗效.方法 自2005年1月至2011年12月经颞下-小脑幕入路显微手术治疗中上岩斜区肿瘤患者32例,回顾性分析患者的临床资料和手术方法.结果 32例患者术后病理证实脑膜瘤20例,神经鞘瘤7例,表皮样囊肿5例.肿瘤全切除22例,次全切除6例,大部切除4例.15例患者术后出现新的神经功能障碍:肢体偏瘫5例,失语3例,动眼神经麻痹3例,滑车神经麻痹2例,三叉神经麻痹7例,外展神经麻痹4例,面神经麻痹2例,听神经麻痹3例.术后随访3 ～12个月,神经功能均得到不同程度恢复.结论 经颞下-小脑幕入路是切除中上岩斜区肿瘤值得推荐的入路,具有操作简单、创伤小、并发症少等优点.但术前应仔细研究影像学资料,准确判断病变的位置来决定是否采用此手术入路.