桥小脑角巨大肿瘤80例临床分析

目的　为桥小脑角巨大肿瘤提供临床鉴别和手术治疗依据。方法　回顾分析８０ 例桥小脑角巨大肿瘤资料。结果　８０ 例肿瘤中，听神经瘤４６ 例（５７５ ％ ） ，脑膜瘤１５ 例（１８８ ％ ） ，上皮样囊肿６ 例（７５ ％ ） ，三叉神经瘤５ 例（６３ ％ ） 及其它少见肿瘤８ 例（１０ ％ ） 。平均年龄４４６ 岁，平均病程４３６ 年。临床表现以一侧听力下降（７０ ％ ） 、共济失调（５８８ ％ ） 及头痛（５３５ ％ ） 为主。后组颅神经损害的发生率（２６３ ％ ） 明显增高。 Ｍ Ｒ Ｉ确诊率达９０９ ％ 。枕下入路手术６８ 例，幕上下联合入路手术１２ 例。肿瘤全切除率５３８ ％ ，面神经保留率８１３ ％ ，手术死亡率８８ ％ ，术后症状改善３６ 例，维持原状３５ 例。随访４２ 例，平均随访期２８ 年。生活自理者３８ 例，复发３ 例。结论　桥小脑角巨大肿瘤种类多样。临床鉴别主要依靠影像学检查。手术疗效令人满意。

The clinical analysis of 80 cases of huge cerebellopontine angle tumors

s Objective To provide clinical identification and surgical methods for various huge tumors of cerebellopontine angle (CPA).Methods Retrospective analysis of 80 cases of huge CPA tumors.Results Of 80 cases 46 were acoustic neuromas (57.5%), 15 meningiomas (18.5%), 6 epidermoid cysts(7.5%), 5 trigeminal neuromas (6.3%) and 8 other rare tumors(10%).Average age was 44.6 years and illness duration was 4.36 years. The major symptoms and physical signs were unilateral hearing loss (70%), ataxia (58 8%) and headache (53 5%). The incidence of posterior cranial nerves injury(26.3%) was evidently high. The correct preoperative diagnosis rate of MRI was 90.9%. 68 cases had been operated through suboccipital approach and 12 cases through combined approach. The complete removal rate was 53.8%, facial nerve retention rate was 81.3% and mortality rate was 8.8%. 71 cases howed condition improved or persisted. 42 cases were followed up for an average of 2.8 years and 38 patients could live by themselves. 3 cases were recurrent. Conclusions The huge CPA tumors were divided several types. CT and MRI were the most sensitive methods for diagnosis. Surgical results were satisfactory.