岩斜区脑膜瘤的显微外科治疗

目的探讨经岩骨乙状窦前入路显微外科治疗岩斜区脑膜瘤的手术特征及并发症。方法回顾性分析经显微手术治疗的12例岩斜区脑膜瘤资料。对肿瘤临床和影像学特征、手术入路、手术切除技巧及术后常见并发症的处理进行研究进行分析。结果全切除9例,大部切除3例。术后顽固性脑水肿2例,一侧肢体瘫痪1例,周围性面瘫3例,脑脊液耳漏2例,腰穿置管持续引流后痊愈。脑脊液鼻漏1例,腰穿引流后及耳咽管堵塞后痊愈。无死亡病例。结论经岩骨乙状窦前入路是处理岩斜区脑膜瘤的主要手术入路。颅底重建技术对于防止术后并发症起到了关键作用。

Microneurosurgery for petroclival meningiomas

Objective The microsurgery of petroclival meningiomas via transpetrosal presigmoid approach and its complications are studied.Methods The clinical and imaging fearnes,surgical approach,operative skills and postoperative complications of 12 cases of petroclival meningiomas resected via transpetrosal presigmoid approach were analyzed retrospectively.Results Tumors were totally removed in 9 cases and subtotally in 3 cases.There were 2 cases of postoperative stubborn cerebral edema,1 case of hemiplegia,and 3 cases of peripheral facial paralysis; there were 2 cases of cerebrospinal fluid otorrhea,and 1 case of cerebrospinal fluid rhinorrhea who got recovery by lumbar spine drainage.No dead case.Conclusion The transpetrosal presigmoid approach is a preferable method for petroclival meningomas.Reconstruction of the skull base is the key to prevent the postoperative complications.