斜坡-齿状突型颅底陷入10例临床分析

目的 探讨经口咽前路减压手术治疗斜坡-齿状突型颅底陷入症的疗效。方法 本组10例，MRI主要表现为斜坡内陷，齿状突突入颅内，延髓及颈段脊髓腹侧受压变形有，形中3例合并枕骨内陷，小脑扁桃体下疝及脊髓空洞。手术切除颅颈部腹侧骨性畸形和增生的结缔组织，解除延髓、脊髓腹侧的压迫。结果 痊愈7例，好转2例，无效1例。无死亡和脑脊液漏，术后软腭裂开2例，经再次修复后愈合。结论 颅底陷入尤其是斜坡—齿状突型是经口腔前路减压的主要适应证；早期诊断与充分减压是获得良好疗效的关键。

Clinical analysis of ten cases of basilar invagination-clivus odontoid process type via transoral microsurgical decompression

Objective To investigate the transoral approach for the decompression of basilar invagination and outcomes. Methods Ten patients with basilar invagination were confirmed by MRI scanning. Clivus invagination and odontoid process made an anterior compression to medullary oblongata and superior cervical spinal cord in all patients. Occipital invagination, tonsilar herniation malformation accompanied with syringomyelia was associated with 3 of these patients. Transoral microsurgical decompression was performed by removal of bony malformation of ventral craniocervical area and proliferative tissues. Results There were seven cases of good recovery, 2 of improvement, and 1 of no changes. No operative mortality and postoprative cerebralspinal fluid leaks occurred. The complication related to surgery was palatal dehiscence in 2, and healed after explorative repair. Conclusion Transoral microsurgical decompression is effective for basilar invagination with ventral compression,and early diagnosis with effective decompression is key to obtain good results.