经枕下乙状窦后锁孔入路治疗听神经瘤的临床体会

目的 总结经枕下乙状窦后锁孔入路切除听神经瘤的手术经验. 方法 采用经枕下乙状窦后锁孔入路对38例听神经瘤进行切除手术.距乙状窦后缘内侧1.5 cm做一小直切口,形成直径2.5～3.0 cm大小骨窗,术毕骨瓣复位固定. 结果本组听神经瘤全切33例,次全切5例;35例面神经解剖保留,2例听力保留;无死亡病例,脑脊液漏1例,术中无一例输血,无皮下积液.结论 经枕下乙状窦后锁孔入路可提供足够的手术空间进行听神经瘤切除,明显减少了医源性损伤,切口愈合好,具备微创性、安全性和有效性.

Clinical experience with acoustic neuroma resection through suboccipito-retrosigmoid keyhole approach

Objective To summarize the clinical experience with acoustic neuroma resection via the suboccipito-retrosigmoid keyhole approach. Methods Thirty-eight patients with acoustic neuroma received surgical tumor resection via the suboccipito-retrosigmoid keyhole approach. During the operation, a small vertical incision was made at 1.5 cm medial to the posterior margin of the sigmoidal sinus to prepare a bone window 2.5-3.0 em in diameter. The bone flap was reduced and fixed after the tumor resection. Results Total tumor resection was performed in 33 cases, and 5 cases had subtotal resection. Anatomical preservation of the facial nerve was achieved in 35 cases and hearing was preserved in 2 cases, No death occurred in these cases. Cerebrospinal fluid leakage occurred after the operation in 1 ease. No patients required blood infusion during the operation, nor was subcutaneous effusion found after the operation. Conclusion Acoustic neuroma can be safely and effectively resected via the suboccipito-retrosigmoid keyhole approach, which allows good exposure of the tumor and causes minimal invasiveness.