红岩骨入路行桥脑小脑角区肿瘤切除术中Labbe静脉的处理

目的：探讨Labbe静脉的解剖变异与术中保护，方法：总结近三年来采用扩大的经岩骨联合入路时，20例患Labbe静脉的走向分布，术中处理经验。结果：将Labbe静脉分为四种类型，I型：从大脑外侧裂方向发出，斜向后与大脑下静脉吻合形成Labbe静脉，汇入横窦，共11例，Ⅱ型：Labbe静脉分布，走向同Ⅰ型，但进入小脑幕硬膜间的静脉湖后汇入横窦，共2例，Ⅲ型：在颞后部多个静脉引流分别单独汇入静脉窦，共5例。Ⅳ型：起于外侧裂后方与大脑下静脉听合而成，静脉管径细小，发育不良，经枕后汇入横窦，共2例，5例患Labbe静脉术中损伤，术后CT检查，2例发生颞叶脑内血肿及梗塞，结论：Labbe静脉解剖变异较大，应据分型采用不同的处理保护方法。

Management of Labbe Veins during Resection of Cerebellopontine Angle Tumors via Transpetrosal Approach

Objective To explore the anatomical variance of Labbe veins and the methods for their preservation during surgical removal of cerebellopontine angle tumors. Methods Data of 20 cases in whom combined transpetrosal approach had been carried out for removal of cerebellopontine angle tumors, were reviewed retrospectively to observe the anatomical variance of Labbe veins and to summarize the experiences in dealing with the Labbe veins. Results In these 20 cases, the Labbes veins could be divided into 4 types. Type I (n=11): the Labbe vein arising from the lateral cerebral fissues is anastomosed with the inferior cerebral vein. Type II (n=2): the distribution of the Labbe vein is the same as type I, but it flows back to the transverse sinus through venous lake in the cerebellar tentorium. Type III (n=5): multiple veins which are formed in the posterior temple lobe and flow individually into the transverse sinus. Type IV (n=2): the Labbe vein is formed in the posterior part of the lateral cerebral Tissue and communicated with the inferior cerebral vein; It is rather anaplastic in nature, relatively smaller in the diameter and finally flows into the transverse sinus. The Labbe veins were damaged during the surgery in 5 cases, of whom, 2 had hematomas and infarctions in the temple lobes. Conclusions Anatomy of the Labbe vein is greatly variant and should be preserved by using different methods according to its anatomical type during the surgery.