应用改良的经岩骨乙状窦前入路治疗岩斜区肿瘤

摘要] 目的 探讨改良岩骨乙状窦前入路在岩斜区肿瘤显微外科治疗中的应用。方法 回顾性分析经改良岩骨乙状窦前入路显微手术治疗的岩斜区肿瘤患者10例,对其临床和影像学特征、手术入路及术后常见并发症进行研究。 结果 肿瘤全切10例，开颅过程中无横窦和乙状窦破裂大出血；术后骨瓣解剖复位，无颅骨缺损；术区颞叶水肿致暂时性语言障碍、肢体肌力下降2例，出院时均恢复；皮下积液2例，皮下积液抽除后加压包扎，配合抗炎治疗治愈；未出现脑脊液漏、听力下降、颅内感染、严重的颅神经损伤及癫痫等并发症。结论 改良经岩骨乙状窦前入路操作简便、快捷，易于掌握；术中避免静脉窦损伤，术区显露充分；颅骨解剖复位，术后并发症少，是岩斜区肿瘤的较佳手术入路，值得推广。

Modified transpetrosal-presigmoid approach to microsurgical removal of petroclival tumors

【Abstract】 Objective To study the operative technique of modified transpetrosal-presigmoid approach in microsurgical treatment of petroclival tumors. Methods the clinical features,operative methods,result of operation and postoperative complications of 10 cases of petroclival tumors resected via the modified transpetrosal-presigmoid approach were analyzed retrospectively. Results Total resection of the tumor was achieved in 10 cases. The main postoperative complications were the transient aphasia and the decrease in muscle strength because of temporal edema in 2 patients, the CSF collection under the skin flap in 2 patients. They were all successfully recovered after management . there were no bone defect、CSF leakage、severe injury to the cranial nerve and the venous sinus after operations. Conclusion The modified transpetrosal presigmoid approach is a preferable method for petroclival tumors because of several predominant advantages.