颞-枕下-经岩骨入路切除岩斜区肿瘤116例报告

目的介绍采用颞-枕下-经岩骨入路切除岩骨斜坡区肿瘤的手术方法。方法分析116例岩斜区肿瘤患者的手术方法,所有病人均采用颞-枕下-经岩骨入路切除肿瘤,其中采用经迷路后-乙状窦前入路110例,经乙状窦入路2例,经迷路-乙状窦前入路2例,经颧弓-经岩骨入路2例。结果肿瘤全切除75例(64.7%),次全切除33例(28.4%),大部切除8例(6.9%)。手术死亡3例,占手术总数2.6%。结论颞-枕下-经岩骨入路适用于病变位于斜坡中线部位,或肿瘤横跨颞骨岩部内侧,侵及中、后颅凹和累及海绵窦、三叉神经切迹(Meckel凹陷)肿瘤的切除,该方法在术中对岩骨斜坡区能够获得良好的暴露。

Temporo-suboccipital Transpetrosal Approach for Tumors of the Petrous and Clival Regions: Experience with 116 Cases

Objective To introduce the temporo-suboccipital transpetrosal approach to remove the tumors in the clivus and/or petrous regions. Methods All of the 116 patients have undergone the temporo-suboccipital transpetrosal approach. The approach has been divided into three variants: retrolabyrinthine presigmoid, trans-sigmoid, translabyrinthine and transcochlear presigmoid. Results In 75 cases, the patients' tumors were totally removed. And 33 tumors were incompletely removed, 8 patients' tumors were largely removed. The postoperative mortality was 2.6%. Conclusion The temporo-suboccipital transpetrosal approach, which has several variants, provides exposure from the sphenoid ridge and cavernous sinus to the foramen magnum. These approaches are suitable for exposure and removaling tumors of cranial base, clival, petroclival, or sphenopetroclival.