额颞-颞下硬膜内入路切除哑铃型三叉神经鞘瘤

目的：探讨额颞-颞下硬膜内人路治疗哑铃型三叉神经鞘瘤的手术技巧及疗效。方法：自2009年1月至2012年9月采用经额颞-颞下硬膜内入路手术治疗哑铃型三叉神经鞘瘤15例。结果：肿瘤全切13例，全切除率为86．67％；2例海绵窦内少许残留。无手术死亡。术后并发-过性动眼神经不完全性麻痹1例，手术后2月内恢复；外展神经麻痹1例，4周后恢复。15例术后随访4～36个月。13例全切除病例无复发；次全切除病例2例术后已分别随访7个月和18个月，未见残余肿瘤增大。结论：额颞-颞下硬膜内入路可作为大多数哑铃型三叉神经鞘瘤切除术的手术入路。

Microsurgical Treatment of Dumbbell Trigeminal Neurinoma under Frontotemporal - Subtemporal In- tradural Approach

Objective ：To explore the microsurgical skill and the curative effect of treatment of dumbbell trigeminal neurinoma under frontotemporal - subtemporal intradual approach. Methods： From January 2009 to September 2012, the clinical data of 15 patients with dumbbell trigeminal neurinoma received microsurgery via frontotemporal - subtemporal intradual approach were analyzed. Results：Total resection was achieved in 13 ca- ses（ 86.67% ）, subtotal resection was performed in the other 2 cases with small portion tumor remained in the cavernous sinuses. No operative death. The transient oculomotor never paralysis occurred in 1 case postopera- tivly. The abducenct nerve paralysis happened in another case. They both recovered after operation. 13 patients were followed up for 4 - 36 months. The cases of total resection had no recurrences. The case of subtotal resec- tion with γ - knife treatment after operation was stable. Conclusions ： The best microsurgical approach for the re- moval of dumbbell trigeminal neurinoma is frontotemporal - subtemporal intradual approach.