颈静脉孔神经鞘瘤的外科治疗

目的 探讨颈静脉孔神经鞘瘤的手术入路及治疗效果。方法 回顾性分析采用显微外科手术治疗颈静脉孔神经鞘瘤２４例，其中颅内型（Ａ型）：肿瘤主体位于桥小脑角（１２例）；骨内型（Ｂ型）：肿瘤主体位于颈静脉孔内，向颅内生长（５例）；颅外型（Ｃ型）：肿瘤主体位于颅外，并向颈静脉孔生长（１例）；混合型（Ｄ型）：肿瘤由颈静脉孔向颅内外生长，呈哑铃型（６例）。Ａ型采用枕下乙状窦后入路，Ｂ型采用远外侧入路，Ｃ型和Ｄ型采

Surgical treatment of jugular foramen schwannomas

Objective To explore the surgical approach and treatment effects of jugular foramen schwannomas.Methods　Twenty-four patients with schwannomas of the jugular foramen underwent microsurgical operations in our hospital. The tumors were classified into four types: Type A, the principal part of the tumor is located at the CPA (12 cases); Type B, a tumor primarily at the jugular foramen with intracranial extension (5 cases); Type C, a primarily extracranial tumor with extension into the jugular foramen (1 case); Type D, a tumor with both intra-and extracranial components (6 cases). The suboccipital retrosigmoid approach was performed for Type A; the far lateral approach for Type B; the combined cervical-mastoidectomy and far lateral approach for Type C and D.Results　Total tumor removal was achieved in 19 cases, subtotal removal in 4 cases, and greater part removal in 1 case. All 24 patients survived after operation.Conclusion　The key of tumorectomy is the choice of surgical approach by the type of tumor extension. And during the operation, it is very important to save the function of the remaining lower cranial nerves.