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目的探讨远外侧入路显微神经外科在治疗颈静脉孔肿瘤的应用。方法回顾性分析采用远外侧入路显微神经外科治疗的15例颈静脉孔区肿瘤患者的手术方法,并对其临床特点、手术操作和并发症等方面予以总结和分析。结果 15例肿瘤均经手术治疗,其中8例全切除、5例次全切除、2例大部分切除;术后病理证实神经鞘瘤10例,脑膜瘤4例,颈静脉球瘤1例;术后7例患者出现后组颅神经损害,2例出现皮下积液。术后随访未见有肿瘤复发。结论远外侧入路可以直接充分暴露颈静脉孔区,最小程度减少对脑干小脑以及周围神经血管的牵拉和干扰,最大程度切除肿瘤和减少术后并发症。
Objective To investigate the application of distal lateral approach to microsurgical neurosurgery in the treatment of jugular foramen tumors. Methods We retrospectively analyzed the surgical methods of 15 patients with jugular foramen tumors treated by far-lateral microsurgical neurosurgery. The clinical features, surgical procedures and complications were summarized and analyzed. Results All the 15 tumors were surgically treated. Among them, 8 were totally resected, 5 were subtotally resected and 2 were mostly resected. Pathological examination confirmed 10 schwannomas, 4 meningioma and 1 cavernous juguloma. After 7 cases of cranial nerve damage occurred in the latter group, 2 cases of subcutaneous effusion. No follow-up of tumor recurrence. Conclusion Far lateral approach can directly expose the jugular foramen region, minimize the pulling and interference of the cerebellum and peripheral nerve blood vessels, remove the tumor to the greatest extent and reduce the postoperative complications.