第四脑室肿瘤显微手术的临床研究

目的 探讨第四脑室肿瘤显微手术的入路。方法 对第四脑室肿瘤29例,分开小脑扁桃体延髓间隙和(或)切除蚓锥及小脑扁桃体显露第四脑室,继而切除第四脑室病变。结果 肿瘤全切25例,大部分切除4例。第四脑室底部桥脑出血5例,血肿量5-15ml,血肿全部清除。术后无新的小脑损伤症状,本组无死亡。结论 不切开小脑蚓部,经小脑扁桃体延髓间隙入路也能提供良好的术野。

Clinical study on microsurgery for neoplasm of the fourth ventricle

Objective To study operative approach of microsurgery for neoplasm of the fourth ventricle. Methods Transcerebellomedullary fissure approach to the fourth ventricle without splitting inferior vermis is performed in the 29 patients. Results Among the 29 patients with fourth ventricle tumor, total removal of the tumor was achieved in 25 cases, subtotal removed in 4 cases. Of the 5 patients with pons hematoma, hematoma was totally removed.After operation,there was no vermal split syndrome,no died case. Conclusion Transcere- bellomedullary fissure approach provides a sufficient operative view-field without splitting the vermis.