桥小脑角区巨大肿瘤诊治的回顾分析

目的　总结桥小脑角区巨大肿瘤的诊治经验。方法　对我科 73例桥小脑角区巨大肿瘤的发病率、临床和影像学表现、定位定性诊断、手术治疗及随访心理治疗结果作回顾性分析。结果　本组 73例桥小脑角巨大肿瘤 (均≥ 4cm)中 ,神经鞘瘤 50例 (68.4% )、脑膜瘤 1 9例 (2 6 .1 % )、胆脂瘤 4例 (5 .6 % )。 73例均有颅神经损害、小脑损害的症状与体征及颅内高压征。 73例中手术全切除 60例 (82 .2 % )、次全切除 1 3例 (1 7.8% )。 56例颅神经损伤中需心理治疗者 40例 (54 .8% ) ,2例死于肺部感染。平均随访 3 - 5年 ,无复发 ,疗效满意。结论　将桥小脑角区巨大肿瘤的临床特点结合影像学检查 ,可作早期定位、定性诊断 ,并有助于手术设计。早诊断、早治疗以及娴熟的显微操作技术是减少并发症 ,提高疗效的关键。手术结合伽玛刀以及随访心理治疗可改善预后 ,提高生存质量。

Retrospective study on the diagnosis, treatment, follow-up and psychotherapy of giant tumor at cerebllopontine angle

Objectives To improve the diagnosis and treatment of the giant tumor at cerebllopontine angle.Methods 73 cases of giant tumor at cerebllopontine angle were analyzed retrospectively.Results Of the 73 cases, were neuromas 50(68.4%), meningiomas 19(26.1%) cholesteatoma 4(5.5%).60(82.2%)of them the tumors were total removed, 13 cases(17.8%) subtotal removaed and 10 cases of residual tumor were treated with gamma knife therapy.2(2.7%)cases died of the complication of pmeumonia. There are 40 cases of psychosomatic diease in the 56 cases of the complication of the cranical nerve deficit.The recurrence rate was zero in the follow-up time of 3-5 years, and good results were got.Conclusions Clinical features, CT and MRI characteristics of the patients are decisive in the early diagnosis and operative design. The early diagnosis and operation, microscopic technique is crucial for reducing post operative complication and improving the therapeutic efficacy.The combination of the operation, gamma knife therapy, follow-up and psychotherapy can improve prognosis and quality of life.