摘要:
Objective To explore the clinical effect of modified anterior subtemporal approach for resection of tumors in petroclival region and cavernous sinus.Methods The data of 30 patients with oncology treated in our hospital from January 2016 to January 2018 were analyzed retrospectively.All patients were treated with modified anterior infratemporal approach for resection of tumors in petroclival region and cavernous sinus.The degree of tumor resection, the incidence of postoperative complications and the quality of life of the patients were observed.Results 18 cases of petroclival tumors and 12 cases of cavernous sinus tumors were confirmed by pathological examination.Total resection was performed in 13 cases, subtotal resection in 10 cases and majority resection in 7 cases.Transient seizure occurred in 3 cases, oculomotor nerve palsy in 4 cases, mild facial numbness in 3 cases, mild facial paralysis in 1 case, hemiplegia in 1 case, no cerebrospinal fluid leakage, intracranial infection, postoperative hematoma and death.The incidence of complications was 40.0%, followed up from 3 months to 4 years after discharge, 23 patients with temporary neurological dysfunction received different degrees of recovery and 7 patients had no recurrence after operation.The recurrence rate of tumor was 14.29% in 6 cases with no recurrence after partial resection, 23 cases with 100 points, 6 cases with 90 points and 1 case with 80 points according to KPS score.Conclusion The modified anterior infratemporal approach is simple, safe, effective and less invasive in patients with petroclival and cavernous sinus tumors, and is suitable for the surgical treatment of tumors in this region.It can be popularized and applied in clinic.%目的 探究改良前颞下入路切除岩斜区及海绵窦区肿瘤的临床效果.方法 选取我院2016年1月至2018年1月治疗的30例肿瘤病例患者,采用回顾性研究进行数据分析,所有患者均采用改良前颞下入路切除岩斜区及海绵窦区肿瘤,观察患者术后肿瘤切除程度、手术并发症的发生情况以及患者的生存质量.结果 术后病理检查证实,岩斜区肿瘤18例,海绵窦区肿瘤12例.肿瘤全切除13例,近全切除10例,大部分切除7例.术后发生暂时性癫痫发作3例、动眼神经麻痹4例、轻度面部麻木3例、轻度面瘫1例、偏瘫1例,无脑脊液漏、颅内感染、术后明显血肿以及死亡病例,并发症发生率为40.0%;出院后随访3个月至4年,具有暂时性神经功能障碍患者均得到不同程度的恢复,23例全切除以及大部分切除患者术后均未复发,7例大部分切除患者中6例术后未复发,1例患者术后肿瘤复发,术后肿瘤复发率为14.29%;术后患者生存质量按照KPS评分标准:100分者23例,90分者6例,80分者1例.结论 在岩斜区及海绵窦区肿瘤患者中进行改良前颞下入路切除肿瘤,操作简捷、安全有效、创伤小,对海绵窦、岩斜区区域操作优势显著,适合这一区域肿瘤的手术治疗,可在临床推广应用.