经迷路下-颈静脉突入路切除颈静脉孔区神经鞘瘤

目的回顾经迷路下-颈静脉突入路手术切除颈静脉孔区神经鞘瘤的病例,探讨该入路的临床价值。方法回顾总结2例经迷路下-颈静脉突入路手术切除的颈静脉孔区神经鞘瘤的临床资料,并复习相关文献。结果2例肿瘤均得到完全切除。术后1例患者出现短暂轻度的后组脑神经损害及面神经不全损害表现（House Brackmann Ⅱ级）;1例患者原先后组脑神经损害表现改善,无面神经损害表现,听力保留;术后均无脑脊液漏发生。术后随访6个月,2例患者面神经或后组脑神经损害均逐渐恢复或代偿,无肿瘤复发。结论经迷路下-颈静脉突入路操作简便,能在保护迷路的基础上充分暴露颈静脉孔区,适用于主体位于颈静脉孔内并向颅内脑池明显扩展的神经鞘瘤的手术切除。     

颈静脉孔及其周围区域肿瘤的外科治疗

目的探讨颈静脉孔及其周围区域肿瘤的最大限度保存功能的手术方法和手术效果。方法回顾分析1999年3月-2005年5月间手术的32例颈静脉孔区肿瘤，根据术前肿瘤性质、大小、位置、听力功能、面神经功能以及后组脑神经功能，分别采用乳突与颈部联合进路（4例）、不移位面神经的颞下窝进路（9例）、移位面神经的颞下窝进路（11例）以及颞下窝进路联合耳蜗进路（8例），分析术后功能保存情况。术中均使用脑神经监护仪，术后均复查CT或MRI。结果32例颈静脉孔区肿瘤，其中副神经节瘤13例、神经鞘膜瘤10例、脑膜瘤2例、巨细胞瘤2例、软骨肉瘤1例、黏液软骨肉瘤1例、腺样囊性癌1例、胚胎性横纹肌肉瘤1例、胆固醇性肉芽肿1例，随访时间3～60个月。26例肿瘤全切，5例近全切除、1例次全切除。术后死亡2例。5例术后脑脊液漏，2例并发颅内感染，均经保守治疗痊愈；术后1周面神经功能（House—Brackmann分级）1～2级13例，3～4级12例，5～6级7例；术后3—60个月随访面神经功能1—2级23例，3—4级7例，5—6级2例；术后听力较术前改善4例、不变10例、减退11例，丧失7例；术后9例无后组脑神经症状，11例出现暂时性麻痹，12例出现永久性麻痹但1—3个月后10例代偿，2例未代偿。结论采用不同手术进路切除颈静脉孔区肿瘤可以达到肿瘤切除的同时最大限度保存功能，维持可接受的生活质量，手术技术及熟悉术后并发症的处理为重要因素。     

枕下经颈-颈静脉突入路达颈静脉孔区的显微解剖研究

目的 研究一期切除颈静脉孔区复杂性肿瘤的微创手术人路。方法 选择经10％福尔马林固定成人头颈标本10具，显微镜下模拟枕下经颈一颈静脉突人路的手术操作，逐层显露颈静脉孔区，研究该区显微解剖特征及显露范围。结果 该人路直接沿乙状窦、颈内静脉的移行方向显露颈静脉孔区结构，其中后颅窝可经枕下显露，颞下窝藉寰椎与下颌升支间的自然间隙显露。通过切除颈静脉突和迷路下骨质分别自后、外、下和上方显露颈静脉孔。头侧直肌是界定颞下窝结构和枕下三角内结构的确切标志。后组颅神经，交感千和颈内动、静脉行于其前方，椎动脉寰椎上段及其周围的静脉丛行于其后方。结论 枕下经颈一颈静脉突人路可自多个方向充分显露颈静脉孔区结构，且可保护面神经、迷路、耳蜗和椎动脉等结构免受不必要的损伤。     

内镜辅助下枕下远外侧髁后入路颈静脉孔区的应用解剖

目的:将神经内镜应用于远外侧入路,为内镜辅助下枕下远外侧手术治疗颈静脉孔区病变提供形态学基础。方法:模拟枕下远外侧入路,应用神经内镜及手术显微镜对10例4%多聚甲醛固定的成人头颈部标本和10例成人颅骨标本的颈静脉孔区进行显微解剖和观测。结果:骨性颈静脉孔形态、大小多变。在保留枕髁和颈静脉结节的前提下,可以充分显露颈静脉孔内外口。颈静脉孔区的血管与神经关系复杂。结论:熟悉颈静脉孔区的显微解剖有利于术中保护重要的神经和血管。应用神经内镜技术,可在不磨除枕髁和颈静脉结节的情况下对颈静脉孔区结构进行良好地显露。     

内镜经口入路颈静脉孔区神经鞘瘤切除术

目的 探讨内镜经口入路切除颈静脉孔区神经鞘瘤的可行性及效果.方法 采用单纯内镜经口入路切除9例颈静脉孔区神经鞘瘤,其中男3例,女6例;年龄15 ～61岁;临床表现:舌下神经麻痹8例次,迷走神经麻痹6例次,舌咽神经麻痹3例次,面神经麻痹1例次,听力下降1例次.结果 9例颈静脉孔区神经鞘瘤均获得完全切除,且保留了该区域的颅神经功能.除1例患者术后出现暂时性吞咽困难及患侧迷走神经麻痹的并发症外,未见其他并发症发生.9例患者术后随访4-29个月,平均14.3个月,所有患者迷走神经和舌咽神经麻痹均得到了改善和恢复,面神经麻痹和听力下降得到了恢复,舌肌运动获得了改善,但半舌萎缩无明显变化.结论 内镜经口人路可以安全、彻底、微创地切除颈静脉孔区神经鞘瘤,并且能够保留和改善后组颅神经功能.     

不同手术入路对颈静脉孔区的显露程度及其临床应用价值探讨

目的比较各颈静脉孔区手术入路的显露范围,为选择恰当的手术入路切除不同范围的颈静脉孔区病变提供解剖学依据。方法成人头颈标本6具随机将标本分为A、B、C三组,每组2具尸头。其中A组应用颈侧入路、B组依次采取鼓室底入路和改良鼓室底入路、C组依次选择Ⅰ型颞下窝入路及改良Ⅰ型颞下窝入路进行颈静脉孔区解剖,比较各手术入路对颈静脉孔区及其周围解剖区域的显露程度。结果颈侧入路对颈静脉孔的颅外部分及咽旁间隙显露良好;鼓室底入路在颈侧入路的基础上进一步显露乳突、乙状窦垂直段、颈静脉球、颈静脉孔神经部;Ⅰ型颞下窝入路又在鼓室底入路的基础上扩大显露外耳道深部、中耳腔及岩骨内颈内动脉垂直段;改良鼓室底入路和改良Ⅰ型颞下窝入路很好地弥补了鼓室底入路和Ⅰ型颞下窝入路对乙状窦水平段和颈静脉孔血管部显露不足的缺陷。结论不同颈静脉孔区手术入路对颈静脉孔区的显露程度各不相同。以此为依据,根据颈静脉孔区病变的范围选择手术入路对有效显露和切除病变,减少结构和功能破坏具有现实的指导意义。     

颈静脉孔的显微外科解剖研究

目的研究颈静脉孔的硬脑膜结构和孔内神经、血管结构的行程及形态特征。方法显微镜下模拟枕下极外侧入路、颈-乳突入路和Fisch颞下窝入路的手术操作，研究10例福尔马林及乳胶灌注头颈标本颈静脉孔的显微解剖特征。结果在颈静脉孔的颅内开口，舌咽神经与迷走、副神经间被纤维或骨性结构隔开。在颈静脉孔内，脑神经行于颈静脉球上方的内侧，舌咽神经位于最前方，所有神经束均可用显微外科技术分开，副神经的脑根同脊髓根一起进入颈静脉孔后又加入迷走神经。颈静脉球及临近颈内静脉接受来自乙状窦、岩下窦、椎静脉丛、舌下神经管静脉丛、髁导静脉及岩斜下静脉的静脉回流。结论颈静脉孔的颅内开口可分为岩部、颈内部(或神经部)和乙状窦部．颈静脉孔内脑神经的不同神经纤维束在整个行程中彼此独立，副神经仅由脊髓根构成。     

乙状窦后入路切除颈静脉孔区哑铃形肿瘤

目的 探讨颈静脉孔区哑铃型肿瘤的手术入路及治疗效果。方法 回顾性分析采用枕下乙状窦后入路切除4例颈静脉孔区哑铃型肿瘤的临床资料。结果 肿瘤全切除3例，大部切除1例，无手术死亡及严重并发症。结论 经乙状窦后入路可以安全切除哑铃型颈静脉孔区肿瘤。术中应注意保护好后组颅神经。     

Surgical management of jugular foramen meningiomas: a series of 13 cases and review of the literature

OBJECTIVE: Primary meningiomas occurring within the jugular foramen are exceedingly rare lesions presumed to originate from arachnoid-lining cells situated within the jugular foramen. The objective of this study is to analyze the management and outcome in a series of 13 primary jugular foramen meningiomas collected at a single center. STUDY DESIGN: Retrospective study. SETTING: Quaternary referral otology and skull base private center. METHODS: Charts belonging to 13 consecutive patients with pathologically confirmed jugular foramen meningioma surgically treated between September 1991 and May 2005 were examined retrospectively. The follow-up of the series ranged from 12 to 120 (mean, 42.8 +/- 27.5) months. RESULTS: Four (28.5%) patients underwent single-stage tumor removal through the petro-occipital transigmoid (POTS) approach. In two patients with preoperative unserviceable hearing, a combined POTS-translabyrinthine approach was adopted. Two patients underwent a combined POTS-transotic approach because of massive erosion of the carotid canal. A modified transcochlear approach type D with posterior rerouting of the facial nerve and transection of the sigmoid sinus and jugular bulb was performed in two patients with a huge cerebellopontine angle tumor component with extension to the prepontine cistern together with massive involvement of the petrous bone and middle ear and encasement of the vertical and horizontal segments of the intrapetrous carotid artery. In one patient with evidence of a dominant sinus on the site of the tumor, a subtotal tumor removal via an enlarged translabyrinthine approach (ETLA) was planned to resect the intradural component of the tumor. Two patients in our series underwent a planned staged procedure on account of a huge tumor component in the neck. One of these patients underwent a first-stage infratemporal fossa approach type A to remove the tumor component in the neck; the second-stage intradural removal of the tumor was accomplished via an ETLA. The last patient underwent a first-stage modified transcochlear type D approach to remove the intradural tumor component followed by a second-stage transcervical procedure for removal of the extracranial component. Gross total tumor removal (Simpson grade I-II) was achieved in 11 (84.6%) cases. Subtotal removal of the tumor was accomplished in two patients. Good facial nerve function (grades I and II) was achieved in 46.1% of cases, whereas acceptable function (grade III) was achieved in the remaining cases 1 year after tumor removal. Hearing was preserved at the preoperative level in all four patients who underwent surgery via the POTS approach. After surgery, no patient recovered function of the preoperatively paralyzed lower cranial nerves. A new deficit of one or more of the lower cranial nerves was recorded in 61.5% of cases. CONCLUSIONS: Surgical resection is the treatment of choice for jugular foramen meningiomas. Among the various surgical techniques proposed for dealing with these lesions, we prefer the POTS approach alone or combined with the translabyrinthine or transotic approaches. Despite the advances in skull base surgery, new postoperative lower cranial nerve deficits still represent a challenge.     

不同手术入路对颈静脉孔区显露程度的比较研究及其临床应用价值探讨

目的比较各颈静脉孔区手术入路的显露范围,为选择恰当的手术入路切除不同范围的颈静脉孔区病变提供解剖依据。方法成人头颈标本6具随机分为A、B、C三组,每组2具尸头。其中A组应用颈侧入路、B组分别采取鼓室底入路和改良鼓室底入路、C组分别选择A型颞下窝入路及改良A型颞下窝入路进行颈静脉孔区解剖,比较各手术入路对颈静脉孔区及其周围解剖区域的显露程度。结果颈侧入路对颈静脉孔的颅外部分及咽旁间隙显露良好;鼓室底入路在颈侧入路的基础上进一步显露乳突、乙状窦垂直臂、颈静脉球、颈静脉孔神经部;A型颞下窝入路又在鼓室底入路的基础上扩大显露外耳道深部、中耳腔及岩骨段颈内动脉垂直段;改良鼓室底入路和改良A型颞下窝入路很好地弥补了鼓室底入路和A型颞下窝入路对乙状窦水平臂和颈静脉孔血管部显露不足的缺陷。结论不同颈静脉孔区手术入路对颈静脉孔区的显露程度各不相同。以此为依据,根据颈静脉孔区病变的范围选择手术入路对有效显露和切除病变,减少结构和功能破坏具有现实的指导意义。     

颈静脉孔区肿瘤术后后组脑神经损伤的评估和处理

目的：分析颈静脉孔区肿瘤术后后组脑神经损伤情况及其处理,以提高对后组脑神经损伤的认识并改进处理方法。方法：32例颈静脉孔区肿瘤患者中,颈静脉球体瘤12例,后组脑神经鞘膜瘤10例,脑膜瘤3例,胆脂瘤1例,颞骨巨细胞瘤2例,纤维瘤病1例,黏液软骨肉瘤1例,胚胎型横纹肌肉瘤1例,腺样囊性癌1例。均采取手术治疗,30例全切,1例近全切,1例大部切除。结果：除1例术后并发颅内出血死亡外,其余31例术后随访1-6年。术后后组脑神经功能仍正常者5例,新出现神经功能损伤者8例,原有神经功能损伤者18例术后出现不同程度的损伤加剧表现。手术前后行气管切开者8例,其中3例出院前拔管,5例带管出院。出院时后组脑神经损伤代偿者20例,失代偿者6例。失代偿者术后随访中3例代偿,2例部分代偿,1例未代偿。结论：颈静脉孔区肿瘤术后后组脑神经损伤是常见并发症,术前应根据患者年龄、神经功能等综合评估,术中应尽量保全神经,早期积极正确的功能锻炼是术后处理的关键。     

Reversible cochleo-vestibular deficits in two cases of jugular foramen tumor after surgery

Primary jugular foramen (JF) tumor, such as glomus jugular tumor or JF schwannoma, may manifest as a lower cranial nerve deficit; in addition, it can be accompanied by deafness or vertigo if it affects the cranial nerve (CN) VIII. Recently, we encountered JF schwannoma 1 and glomus jugulare tumor 1. Both cases invaded the adjacent cerebellopontine angle, leading to cochleo-vestibular deficits prior to the operation. After surgery, recovery of the audiovestibular function, including hearing, auditory brainstem response and caloric response, was anticipated in both patients. Therefore, cochleo-vestibular deficits in JF tumors can be attributed to compression neuropathy, rather than tumor infiltration.     

Jugular foramen fibromatosis in a 3-month-old male

A 3-month-old male with a chief complaint of episodic choking with feeds and a hoarse cry is presented. Left eye ptosis and asymmetric soft palate elevation were detected on physical examination. Fiberoptic examination showed a left vocal fold paresis and pooling of secretions in the pyriform sinuses. MRI demonstrated an ill-defined lesion at the left jugular foramen extending into the left carotid sheath. A fine needle biopsy revealed spindle shaped cells consistent with fibromatosis. The histopathology of fibromatosis and the differential diagnosis of jugular foramen masses in children will be described. To our knowledge, this represents the earliest reported case of fibromatosis in the jugular foramen.     

Anatomical study of jugular foramen in the neck

IntroductionThe anatomical complexity of the jugular foramen makes surgical procedures in this region delicate and difficult. Due to the advances in surgical techniques, approaches to the jugular foramen became more frequent, requiring improvement of the knowledge of this region anatomy.ObjectiveTo study the anatomy of the jugular foramen, internal jugular vein and glossopharyngeal, vagus and accessory nerves, and to identify the anatomical relationships among these structures in the jugular foramen region and lateral-pharyngeal space.MethodsA total of 60 sides of 30 non-embalmed cadavers were examined few hours after death. The diameters of the jugular foramen and its anatomical relationships were analyzed.ResultsThe diameters of the jugular foramen and internal jugular vein were greater on the right side in most studied specimens. The inferior petrosal sinus ended in the internal jugular vein up to 40 mm below the jugular foramen; in 5% of cases. The glossopharyngeal nerve exhibited an intimate anatomical relationship with the styloglossus muscle after exiting the skull, and the vagal nerve had a similar relationship with the hypoglossal nerve. The accessory nerve passed around the internal jugular vein via its anterior wall in 71.7% of cadavers.ConclusionAnatomical variations were found in the dimensions of the jugular foramen and the internal jugular vein, which were larger in size on the right side of most studied bodies; variations also occurred in the trajectory and anatomical relationships of the nerves. The petrosal sinus can join the internal jugular vein below the foramen.     

Anomalies of transverse and sigmoid sinuses associated with contracted jugular foramina

Variations of the durai venous sinuses may present puzzling diagnostic and operative problems in the presence of thrombophlebitis. Such variations in sinuses of the posterior cranial fossa are usually associated with contracted jugular foramina and a small internal jugular vein. In the present study 214 sides of the bases of the macerated skulls were examined for the contracted jugular foramen and associated anomalies of the durai venous sinuses. In ten sides (4.67%) out of these an anomaly of the durai sinus of the posterior cranial fossa was found (two of right side and eight of left side). Out of these one case of right side was associated with the absence of groove for both transverse and sigmoid sinuses. All other cases were associated with the absence of groove for transverse sinus alone on the abnormal side. In seven cases out of these the jugular foramen was contracted on the abnormal side. The embryological basis and clinical significance of the anomalies of transverse and sigmoid sinuses is discussed here.     

Chondrosarcomas of the jugular foramen

Objectives/Hypothesis: Chondrosarcomas of the jugular foramen are extremely rare tumors. Our review of the literature revealed eleven previously reported cases. The aim of this study is to describe the presenting symptoms, radiographic findings, operative procedures, and postoperative outcome of five histologically confirmed cases of chondrosarcomas arising from the jugular foramen. A review of the literature is also presented. Study Design: Retrospective study of an quaternary referral otology and skull base private center. Methods: Five cases of surgically treated and pathologically confirmed jugular foramen chondrosarcomas were identified. The follow‐up of the series ranged from 23 to 42 months (mean, 32.8 ± 7.7 months). Results: A single stage procedure was adopted in all the cases. Two patients underwent type A infratemporal approaches, one patient underwent a transotic approach extending to the neck with ligature of the internal jugular vein, one patient underwent a petro‐occipital transigmoid approach, and one patient underwent a combined petro‐occipital transigmoid–transotic approach. Gross total tumor removal was achieved in all patients. The most common complications were lower cranial nerve deficits. To date, no recurrence or residual tumors have been observed at radiological controls. Conclusions: We believe that the primary treatment for chondrosarcomas of the jugular foramen is gross total surgical resection of the tumor. It is our philosophy to reserve postoperative radiotherapy for patients with histologically aggressive tumors, as well as in cases with subtotal resection and recurrent tumors.     

Surgical management of jugular foramen schwannomas with hearing and facial nerve function preservation: a series of 23 cases and review of the literature

OBJECTIVE: Schwannomas of the jugular foramen are rare lesions and controversy regarding their management still exists. The objective of this retrospective study was to analyze the management and outcome in a series of 23 cases collected at a single center. SETTING: This study was conducted at a quaternary private otology and skull base center. METHODS: Charts belonging to patients with a diagnosis of jugular foramen schwannoma attending our center between May 1988 and April 2006 were examined retrospectively. RESULTS: The study group consisted of 23 patients. One patient (a 73-year-old woman) with normal lower cranial nerves function was managed with watchful expectancy and regular clinical and radiologic follow ups. The infratemporal fossa approach-type A (IFTA-A) was performed in 3 cases. One patient underwent a transcochlear-transjugular approach. Of the 22 patients surgically treated, 12 patients were operated on by the petrooccipital transsigmoid approach (POTS). In one patient with a preoperative dead ear, a combined POTS-translabyrinthine approach was adopted. Two patients were operated on through the POTS approach combined with the transotic approach. In another case (a 67-year-old woman), a subtotal tumor removal through a transcervical approach was planned to resect a 10-cm mass in the neck. One patient underwent a first-stage combined transcervical-subtotal petrosectomy approach to remove a huge tumor in the neck; the second-stage intradural removal of the tumor was accomplished through a translabyrinthine-transsigmoid-transjugular approach. The last patient underwent a first-stage combined transcervical-subtotal petrosectomy approach to remove the neck tumor component; this patient is now waiting for the second-stage intradural removal of the tumor. Complete tumor removal was accomplished in 21 cases and in one case, a residual schwannoma was left in place in the area of the jugular foramen. The 3 patients who were operated on by IFTA-A underwent permanent anterior transposition of the facial nerve. At 1-year follow up, 2 of these patients had House-Brackmann grade I and 1 reached grade IV. The patient who underwent a transcochlear-transjugular approach had a permanent posterior transposition of the facial nerve. At 1-year follow up, he had grade III facial nerve function. Postoperative facial nerve function was normal (House-Brackmann grade I) in all patients operated on by the POTS approach. Twelve patients had hearing-preserving surgery using the POTS approach. Good hearing was preserved in 10 cases (83.3%), the majority of whom (58.3%) maintained their preoperative hearing level. There was no perioperative mortality. One patient (4.5%) experienced a postoperative cerebrospinal fluid leak. After surgery, all patients did not recover the function of the preoperatively paralyzed lower cranial nerves. A new deficit of one or more of the lower cranial nerves was recorded in 50% of cases. So far, no patient has experienced recurrence during the follow-up period as ascertained by computed tomography or magnetic resonance imaging. CONCLUSIONS: Surgical resection is the treatment of choice for jugular foramen schwannomas. The POTS approach allowed single-stage, total tumor removal with preservation of the facial nerve and of the middle and inner ear functions in the majority of cases. Despite the advances in skull base surgery, new postoperative lower cranial nerve deficits still represent a challenge.     

枕下经颈-颈静脉突入路切除颈静脉孔肿瘤临床初探

目的探讨枕下经颈-颈静脉突(STJP)入路切除颈静脉孔肿瘤的临床价值及适用范围。方法回顾总结2000年1月以来经STJP入路手术的14例颈静脉孔肿瘤病人的临床资料及术后随访情况。结果14例颈静脉孔肿瘤中,1例局限于颈静脉孔区;5例向颅内发展;其余8例虽肿瘤主体位于颅内,但部分瘤体长至颅外,其中2例跨枕大孔进入颈椎管上部,6例呈哑铃型长出至颈静脉孔外口处,后者中有2例向前累及颈动脉鞘。手术全切除10例,近全切除1例,次全切除3例。无1例发生术后脑脊液漏。术后1例病人出现短期患侧眼外展麻痹和面神经不全损害(HBⅢ级),余13例(92.9%)无新增脑神经损害表现。除1例病人失访外,其余病人均随访3~60个月,随访时术前原脑神经损害均已逐渐恢复或代偿,无1例残留吞咽困难。结论STJP入路显露范围较广泛,操作简便,不破坏迷路,无需轮廓化面神经管,对颅底结构破坏较少,适用于切除主体向颅内发展为主的颈静脉孔肿瘤。     

Removal of infratemporal fossa schwannoma via a transmandibular transpterygoid approach

Trigeminal schwannomas are commonly located in the intracranium, and extracranial schwannomas limited to the infratemopral fossa (ITF) are extremely rare. Trigeminal mandibular schwannoma was found in the left ITF of a 48-year-old man who presented with a 1-year history of left facial pain and trismus. The schwannoma was completely removed by a transmandibular transpterygoid approach with no major complications. This case is discussed with a review of the literature on this rare occurrence, focusing on the surgical approach.     

颈静脉孔区脑神经鞘瘤

目的探讨颈静脉孔区脑神经鞘瘤的诊断和治疗。方法总结2001年11月至2005年6月手术治疗的11例颈静脉孔区脑神经鞘瘤，其中颅内型5例，颈静脉孔型3例，颈部型1例，混合型2例。手术方法包括迷路进路3例，乙状窦后进路2例，颞下窝进路6例。结果11例手术均全切除肿瘤。术后无一例出现死亡、偏瘫、昏迷及颅内出血等严重并发症。2例乙状窦后进路患者术后听力仍部分保留。术中均保留面神经解剖完整性。面神经功能采用House-Braekmann分级，颅内型5例，术后I级2例，Ⅱ级2例，Ⅳ级1例。颞下窝进路6例，术后Ⅰ级1例，Ⅲ级1例，Ⅳ级2例，V级2例；其中面神经功能Ⅰ级者术中未行面神经移位。术前后组颅神经障碍者9例，术后后组颅神经障碍者11例。吞咽功能出院前完全代偿者7例，基本代偿者1例，部分代偿者2例，失代偿者1例；术后6个月除1例失代偿者仍需长期软食，部分代偿外，其余10例均能正常饮食。11例患者术后均出现声嘶，术后6个月，声嘶均好转。术后有2例患者出现脑脊液漏，表现为切口处皮下积液，均经局部加压包扎后好转，其中1例于术后2个月再次出现脑脊液漏，经局部麻醉下漏口修补后治愈。11例患者均未出现颅内感染。结论颈静脉孔区脑神经鞘瘤手术效果好，依据磁共振成像检查对肿瘤分型采取不同的手术方法。对颅神经功能的保护和锻炼是治疗的重点。