论文部分内容阅读
目的探讨颞下经小脑幕入路切除中上岩斜区肿瘤的手术技巧。方法回顾性分析2003年6月-2010年4月收治的43例中上岩斜区肿瘤,其中男19例,女24例,年龄23～64岁,平均42岁,病程2个月～3年,平均14个月,均采用颞下经小脑幕入路,对肿瘤与中上岩斜区毗邻结构关系进行评估,分离肿瘤与天幕及岩斜部脑膜的近端粘连,由近及远分块切除肿瘤,逐渐分离扩大脑干、下视丘、海绵窦与肿瘤之间的间隙,避免直接接触上述重要结构,彻底切除肿瘤。观察术后疗效和并发症。结果 43例患者中肿瘤完全切除31例(72.1%),次全切除7例(16.3%),大部切除5例(11.6%),死亡1例(2.3%)。23例术后出现部分神经功能障碍。术后随访3～48个月,神经功能障碍均得到不同程度恢复。结论颞下经小脑幕入路切除中上岩斜区肿瘤具有手术路径短、容易暴露的优点。缩小肿瘤体积、扩大操作空间是此类手术的关键。
Objective To investigate the surgical techniques for the removal of mid-upper petroclival tumors by infratemporal subtotal beak approach. Methods Retrospective analysis of 43 patients with upper-middle oblique incision admitted from June 2003 to April 2010 included 19 males and 24 females, aged from 23 to 64 years with an average of 42 years and the course of disease ranging from 2 months to 3 years , An average of 14 months, are under the infratemporal transmucocele approach, the tumor and the rock adjacent to the rock structure to assess the adjacent structure, separating the tumor and the cantilever and petrous apex of the meningeal adhesion, from near and far block Excision of the tumor, gradual separation and expansion of the brain stem, hypothalamus, cavernous sinus and the gap between the tumor, to avoid direct contact with the important structure, complete removal of the tumor. Observation of postoperative efficacy and complications. Results Of the 43 patients, 31 (72.1%) had complete resection of tumor, 7 (16.3%) had subtotal resection, 5 (11.6%) had subtotal resection and 1 (2.3%) had died. Twenty-three patients had partial neurological dysfunction. After 3 to 48 months of follow-up, neurological dysfunction were recovered to varying degrees. Conclusions Temporomandibular tentorium resection of the middle-upper petroclival region tumor has the advantages of short operative path and easy exposure. Tumor volume reduction, expand the operating space is the key to such surgery.