岩斜区脑膜瘤的显微外科治疗(附18例报告)

目的提高岩斜区脑膜瘤的手术效果。方法回顾性分析我院自１９９５年１月至１９９７年１１月连续收治的１８例岩斜区脑膜瘤。１３例肿瘤大于４．５ｃｍ。采用了经颞下小脑幕、颞下－乙状窦前、颞下－迷路、枕下－极外侧入路。结果肿瘤全切除１１例（６１％），其中２例术后发生Ｗｅｂｅｒ’ｓ综合征，１例死于肺炎。结论影响手术预后的最主要因素是小脑前下动脉（ＡＩＣＡ）、小脑上动脉（ＳＣＡ）和小脑后下动脉（ＰＩＣＡ）及其供应脑干的穿通支被肿瘤包裹和脑干受累，血管因素可能更为重要。

Microsurgical treatment of petroclival meningiomas(report of 18 cases

Objective To improve the surgical outcome of petroclival meningiomas. Methods Eighteenconsecutive cases of petroclival meningiomas presented in our hospital during a period from 1995 to 1997 were studiedretrospectively. Thirteen lesions were greater than 4.5cm in their largest dimension. Subtemporal-transtentorial, sub- temporal-presigmoid, subtemporal-translabyrinthine and suboccipital-far lateral approaches were used for tumor resection. Results Total removal of the tumor was achieved in 11 patients (61%). Among them, 2 developed Weber'ssyndrome postoperatively, 1 died of pneumonia. Conclusions The main influential factors on surgical results wereengulfment of SCA, AICA, PICA and their perforators to the brainstem as well as compromise of the brainstem. Thevascular factor might be more important.