神经内镜颞下锁孔Kawase入路切除岩斜区脑膜瘤

目的探讨内镜颞下锁孔Kawase入路切除岩斜区脑膜瘤的方式及治疗效果。方法回顾性分析用内镜经颞下锁孔Kawase入路切除5例岩斜区脑膜瘤患者的临床资料和术后效果及并发症。结果本组患者中4例患者的肿瘤完全切除,1例患者肿瘤次全切除;无死亡病例。术后复查CT示手术区域和手术路径均无脑组织挫伤。1例复发脑膜瘤患者术后出现嗜睡、右侧肢体偏瘫,经治疗后意识恢复正常、右侧肢体肌力改善;3例患者术后出现新发颅神经轻度损害表现,经治疗后2例好转、1例无明显改善;1例患者术后无任何并发症,且术前症状术后明显改善。术后随访13~20个月,患者均正常生活,未见肿瘤复发或快速生长。结论内镜颞下锁孔Kawase入路手术具有微创、暴露范围广、视野清晰等优点,治疗岩斜区脑膜瘤的效果良好、安全性高。

Neuroendoscopic subtemporal keyhole Kawase approach for petroclival meningioma resection

Objective To investigate the method and effect of endoscopic subtemporal keyhole Kawase approach for petroclival meningioma resection.Methods The clinical data,postoperative results and complications of 5 patients with petroclival meningiomas resected by the endoscopic keyhole Kawase approach were analyzed retrospectively.Results Total resection was achieved in 4 cases,and subtotal resection in 1.There was no death.Brain tissue contusion was not observed among these patients.1 patient with recurrent meningioma who suffered from postoperative lethargy and right hemiplegia,and consciousness returned to normal and muscle strength of right limb improved after treatment.3 patients presented the mild dysfunction of cranial nerves,which 2 improved and 1 showed no significant improvement after treatment.1 patient had no postoperative complications,and the preoperative symptoms were significantly improved after operation.The follow-up from 13 to 20 months showed all patients had a normal life without tumor recurrence or rapid growth.Conclusions Endoscopic subtemporal keyhole Kawase approach has the advantages of minimal invasion,wide exposure and clear vision.It is effective and high safety in petroclival meningioma resection.