颈静脉孔区肿瘤的显微外科治疗

目的探讨颈静脉孔区肿瘤的显微手术治疗方法及效果。方法36例颈静脉孔区肿瘤患者行显微外科手术切除,观察切除程度、死亡率、术前术后的颅神经功能和主要并发症。结果全切29例,次全切4例,部分切除3例。术后死亡1例,脑脊液漏1例,出现新的神经功能损害7例。术后1个月KPS分级超过80分28例,术后6个月超过80分32例;术后面神经功能Ⅰ～Ⅱ级(H-B分级)31例;术前有残余听力,术后听力保存者11例;全切后复发3例。结论选择合适的入路进行显微外科手术,可以全切肿瘤并较好的保护或恢复颅神经功能,特别是体积较大和颅神经受损明显的肿瘤,手术切除是首选。

Microsurgical treatment of jugular foramen tumor

Objective To explore the diagnosis and microsurgical treatment and to observe the clinical effects of surgical treatment in patients with jugular foramen tumor. Methods Thirty-six patients with JF tumors who were mircosurgical treated by the same group were retrospectively studied. Cranial nerve function, preoperative and postoperative complications, follow-up data were presented and discussed. Results Gross total tumor removal was achieved in 29 patients,subtotal removal in 4 cases, partial removal in 3 cases, postoperative cerebrospinal fluid leakage in 1 cases, postoperative new cranial nerve defects in 7 cases,death in 1 case. KPS scale was adopted as a criterion to evaluate the patients'quality of life, more than 80 in 28 cases in 1 month and in 32 cases in 6 month postoperatively. Favorable facial function in 6 month postoperatively (House-Brackmann grade system in Grade 1 and Grade 2) was noted in 31 patients. The postoperative level of hearing was preserved in 11 patients with residuary hearing. Tumor recurrence occured in 3 cases in follow-up period. Conclusion According to the difference of tumor, the surgical total removal is possible depended on microsurgical operation with proper approach. Surgical treatment is the primary mode of treat9ment for tumors associated with big size and impairment of lower cranial nerves.