Zixiang Yi, Rong Zhang, Jinmei Cheng, Chang Lin, Gongbiao Lin
Otolaryngology Institute of Fujian Province and First Affiliated Hospital of Fujian Medical University, Fuzhou, China.
Otol Neurotol. 2005 Jul;26(4):741-7. doi: 10.1097/01.mao.0000178129.43612.46.
This article is designed to relate our experiences with a glenoid fossa approach for exposing the outer border of extensive lesions in the lateral skull base.
In this series, there were five large paragangliomas with the longest diameter of 6.5 cm in length, one large jugular schwannoma with extratemporal components, and one severe case of petromastoiditis with otogenic pachymeningitis, edema of the temporal lobe, and mental disorder. All lesions of these cases were treated via a glenoid fossa approach combined with other reasonable approaches.
The glenoid fossa approach resulted in crucial advantages: 1) it effectively exposes the outer border of extensive lesions in the lateral skull base; 2) it provides safe distal control of the facial nerve and internal carotid artery in the skull base; 3) it obviates the need for anterior transposition or rerouting of the facial nerve; and 4) it obviates sacrifice of the intact middle ear or section the mandibular condyle. There is no postoperative mandibular dysfunction because the mandibular articular capsule and articular tubercle are kept intact.
On the basis of our experiences, the glenoid fossa approach is a safe, quick, and useful design for adequate exposure of the outer border of extensive lesions in lateral skull base surgery.
本文旨在阐述我们采用关节盂窝入路暴露外侧颅底广泛病变外侧边界的经验。
在本系列病例中，有5例最大直径为6.5厘米的大型副神经节瘤、1例伴有颞外成分的大型颈静脉神经鞘瘤以及1例伴有耳源性硬脑膜炎、颞叶水肿和精神障碍的严重岩乳突炎病例。这些病例的所有病变均通过关节盂窝入路联合其他合理入路进行治疗。
关节盂窝入路具有关键优势：1）能有效暴露外侧颅底广泛病变的外侧边界；2）可在颅底对面神经和颈内动脉进行安全的远端控制；3）无需对面神经进行前移位或改道；4）无需牺牲完整的中耳或切断下颌髁突。由于下颌关节囊和关节结节保持完整，术后无下颌功能障碍。
基于我们的经验，关节盂窝入路是外侧颅底手术中充分暴露广泛病变外侧边界的一种安全、快速且实用的术式。
