桥小脑角脑膜瘤经枕下乙状窦后入路显微手术策略

目的探讨桥小脑角脑膜瘤的临床特点，经枕下乙状窦后入路的显微手术治疗技巧。方法收集2006年1月-2010年12月山西医科大学附属第一医院采用枕下乙状窦后入路显微手术治疗的31例桥小脑角脑膜瘤的临床资料，对其在肿瘤切除程度、面听神经功能保护等方面进行回顾性研究。结果31例中行Simpson Ⅰ级切除8例（25．8%），Ⅱ级17例（54．8％），Ⅲ级6例（19．4％），术后临床症状改善者22例，基本同术前者7例，症状加重者2例，无死亡病例，面神经功能保留者23例（74．2％），听力保留者21例（67．7％）。结论枕下乙状窦后入路显微手术治疗桥小脑角脑膜瘤安全、有效，术中结合电生理监测及神经内镜技术，可以提高肿瘤的全切率，面听神经功能保留率，改善患者术后生活质量。

Microsurgical strategies for cerebellopontine angel meningiomas through suboccipital retrosigmoid approach

Objective To explore the clinical features of cerebellopontine angel meningiomas（CPAM）, and microsurgical skills of CPAM through suboccipital retrosigmoid approach. Methods A retrospective analysis on the 31 patients undergoing surgical removal of historically confirmed CPAM between January 2006 and December 2010 was performed with regard to extent of resection, changes of nerves function postoperatively, and so on. Results Simpson I resection was done in 8（25.8%） patients, Simpson lIresection in 17（54.8%）, and Simpson m resection in 6 patients（19.4%）. Postoperative status was improved in 22 cases, received unchanged in 7 and aggravated in 2, presservation of facial nerves in 23（74.2%） and audition in 21（67.7%）. Conclusion Microsurgical treatment of CPAM through suboccipital retrosigmoid approach is safe and efficient. Intraoperative monitoring of facial and acoustic nerves, application of neuroendoscopes are all the keys to improve the therapeutical outcomes and the postoperative quality of life.