枕下乙状窦后-内听道上入路显微手术切除岩斜区脑膜瘤

目的总结应用枕下乙状窦后-内听道上入路显微手术切除岩斜区脑膜瘤的方法和经验。探讨岩斜区脑膜瘤的显微手术技术,提高肿瘤手术切除程度与术后疗效。方法回顾性分析采用枕下乙状窦后-内听道上入路显微手术治疗的11例岩斜区脑膜瘤的临床资料,并对手术方法进行分析。结果肿瘤全切除8例(72.7%),次全切除3例。术后新增脑神经损害2例(18.2%),无手术相关死亡病例。结论应用枕下乙状窦后-内听道上入路,采用显微神经外科技术处理岩斜区脑膜瘤,可获得满意的手术疗效。该入路明显扩大对中颅窝和上斜坡的显露,是切除主体位于后颅窝,同时累及中颅窝的岩斜区肿瘤的良好途径,掌握手术技巧和术中注意事项,有利于提高肿瘤切除率和疗效。

Microsurgical resection of petroclival meningiomas through trans-suboccipital retrosigmoid suprameatal approach

Objective To summarize the clinical experience for treatment of petroclival meningiomas by microsurgical resection through trans-suboccipital retrosigmoid suprameatal approach(SRSA).Methods The clinical data of 11 patients with petroclival meningioma were retrospectively reviewed and analyzed.Results All patients were undertaken microsurgical tumor resection through SRSA,including 8 cases with complete gross tumor resection and 3 cases with partial tumor resection.Two cases had cranial nerve defect after operation.No patient died due to operation.Conclusion SRSA can increase the exposure space of the petroclival,middle fossa and upper clivus,it is therefore a very good approach to removing petroclival meningioma,especially those tumors invading both the petroclival and middle fossa or locating mainly at the posterior fossa.SRSA results in more tumor mass resection,good recovery of patients and few cranial nerve defects.