显微外科治疗枕骨大孔区肿瘤

目的：探讨枕骨大孔区肿瘤的合理手术入路，进一步提高其手术治疗效果。方法：全组手术均在显微外科条件下完成，其中14例取枕下正中入路切除，8例取枕下远外侧入路切除。结果：本组全切除肿瘤18例，次全切除4例。无手术死亡。讨论：由于位置深在，解剖结构重要，复杂，枕骨大孔区肿瘤的手术切除有一定的难度和危险。应根据肿瘤的部位，大小和性质选用枕下正中入路可枕下远外侧入路，枕下远外侧入路更适合于枕骨大孔区前方和前外侧方肿瘤的显微手术。

Microsurgical treatment of the foramen magnum region tumors

Objective To develop rational surgical approach and to further improve the surgical outcomes of the foramen magnum tumors. Methods Median suboccipital approach was adopted in 14 cases, and far lateral suboccipital approach in 8 cases. Operation was carried out under microsurgical conditions. Results Total tumor removal was accomplished in 18 cases, and subtotal removal in 4 cases. No one died. Conclusion With complex and important anatomical structures and deep site, the foramen magnum region tumor is dangerous and difficult to resect. Median or far lateral suboccipital approach should be selected according to the size,position and pathohistological characteristics of the tumor. Far lateral suboccipital approach is more suitable for microsurgical and anterolateral portion of the foramen magnum region.