后颅窝骨瓣开颅、深部肌群分层缝合技术在枕下乙状窦后入路手术中的应用

目的 探讨枕下乙状窦后人路骨瓣开颅和复位,后颅窝深部肌群分层切开、缝合术的手术方法及临床应用. 方法上海市第十人民医院神经外科自2003年5月至2005年5月应用枕下乙状窦后入路骨瓣开颅、深部肌群分层切开缝合术治疗40例桥脑小脑角区肿瘤患者,对其临床资料进行同顾性分析.结果 骨瓣开颅均顺利完成,手术视野良好,平均用时40～70min;2例患者术后出现皮下积液,无脑脊液漏发生,多数患者数后第6天头部即可自由活动.结论经枕下乙状窦后入路骨瓣开颅、深部肌群分层缝合技术安全、快捷,可降低术后脑脊液漏、假性脑膨出的发生,并可使头部早期恢复自由活动.

Craniotomy for posterior fossa and deep muscles incision and suture technique in suboccipital retrosigmoidal approach

Objective To probe the technical processes of the suboccipital retrosigmoidal craniotomy with replacement of bone flap and deep muscles incision and suture and its clinical application. Methods The data of 40 patients undergoing suboccipital craniotomy to the cerehello-pontine angle lesions, deep muscles incision and suture in our hospital from May, 2003 to May, 2005 were analyzed retrospectively. Results All the procedures of craniotomy including removal of the bone flap, deep muscles incision and suture were accomplished safely with an average operation time of 40-60 min. Two patients appeared post-operative subcutaneous hydrops without CSF leakage and the majority can move their head freely sixth day after the operation. Conclusion Suboccipital retrosigmoidal craniotomy with replacement of bone flap, and deep muscles incision and suture, being a safe and feasible method, may decrease the happening of postoperative CSF leakage and encephalocele, and accelerate the recover of head movement.