经岩骨乙状窦前入路显微外科治疗岩斜区肿瘤

目的 探讨岩斜区肿瘤经岩骨乙状窦前入路显微外科治疗的临床疗效。方法 回顾性研究经显微手术治疗的23例岩斜区肿瘤，对肿瘤病理类型、临床和影像学特征、手术入路、手术切除技巧及术后常见并发症的处理进行系统分析。结果 在手术显微镜下肿瘤全切除16例，近全切除4例，大部分切除3例，无手术死亡。结论 经岩骨乙状窦前入路可全切除岩斜区肿瘤。该手术入路对颞叶和小脑牵拉轻，可为岩斜区肿瘤手术切除提供良好的暴露。

Microsurgical treatment of petroclival tumors by transpetrosal presigmoid approach

Objective To explore clinical curative effect of microsurgery of petroclival tumors by transpetrosal presigmoid approach. Methods A series of 23 patients of petroclival tumors resected by microneurosurgery were analyzed retrospectively, including tumors histological types, clinical and preoperative MRI features, operative approaches, surgical technique and common postoperative complications. Results Total resection of the tumor was achieved microsurgically in 16 cases, subtotal resection in 4 cases, partial resection in 3 cases. No patient died in this series. 8 patients presented worsening crainal nerves palsies postoperatively. CSF leaks were uncommon, occuring in 2 patients. Conclusion The tumors in petroclival region can be totally resected by transpetrosal presigmoid approach. The advantages were offered by this approach such as the temporal lobes and cerebellum are minimally retracted; the operative distance of petroclival tumors is shortened with exposure of clivus and juxta-clival region.