骨瓣开颅和复位在枕下乙状窦后手术入路中的应用

目的探讨枕下乙状窦后入路骨瓣开颅和复位的手术方法及临床应用。方法对31例桥小脑角区病变经枕下乙状窦后入路骨瓣开颅手术病人的病历资料进行回顾分析。结果骨瓣开颅均顺利完成,获得了满意的术野显露,骨瓣切除平均用时48 min。术后无一例发生脑脊液感染和发热,1例拆线后第2天发现脑脊液通过裂开的切口外漏,经及时处理,7 d后痊愈出院。结论枕下乙状窦后入路骨瓣开颅是安全、快捷、可行的。骨瓣复位可以降低术后脑脊液漏和感染的发生。

Suboccipital retrosigmoidal craniotomy with replacement of bone flap for the lesions of the cerebellopontine angle

Objective To probe the technical processes of the suboccipital retrosigmoidal craniotomy with replacement of bone flap and its clinical application. Methods The data of 31 patients undergoing suboccipital retrosigmoidal craniotomy for the cebellopontine angle lesions were analyzed retrospectively. Results All the procedures of craniotomy including removal of the bone flap were accomplished smoothly and safely within 48 minutes averagely. No postoperative cerebral spinal fluid (CSF) infection and fever occurred. Only one patient was found CSF leakage from the split incision after taking out stitches and quickly healed after the prompt treatment. Conclusion Suboccipital retrosigmoidal craniotomy with replacement of bone flap is safe and feasible. It may decrease the possibility of postoperative CSF leakage or infection for the cerebellopontine angle lesions.