Goksu Nebil, Bayazit Yildirim A, Bayramoglu Ismet, Isik Berrin, Yilmaz Metin, Kurtipek Omer, Uygur Kemal
Department of Otolaryngology and Head and Neck Surgery, Faculty of Medicine, Gazi University, Besevler, Ankara, Turkey 06150.
Surg Neurol. 2006 Jun;65(6):631-4; discussion 634. doi: 10.1016/j.surneu.2005.09.031.
The aim of this study was to present our technique of posterior fossa surgery and to evaluate whether cerebellar retractors are needed.
Since March 1989, more than 500 surgeries were performed through retrosigmoid approach, and our surgical technique was described. The data were evaluated whether or not cerebellar retractors were used in the operations.
The surgeries were vestibular neurectomy, acoustic neuroma removal, and neurovascular decompression in 351, 135, and 14 patients, respectively. Cerebellar retractors have not been used in vestibular neurectomies and in most acoustic neuroma surgeries. The cerebellar retractors have been used in all of the neurovascular decompression surgeries where better exposure of the root entry zones of the cranial nerves is needed, and intracranial endoscopy is applied for further exposure and decompression of the vascular loop.
There is no need for cerebellar retractors when adequate conditions such as patient positioning, adequate anesthesia techniques, and surgical manipulations are applied in posterior fossa approach except for neurovascular decompression and some of the acoustic neuroma surgeries.
本研究的目的是介绍我们的后颅窝手术技术，并评估是否需要小脑牵开器。
自1989年3月以来，通过乙状窦后入路进行了500多例手术，并描述了我们的手术技术。对手术中是否使用小脑牵开器的数据进行了评估。
手术分别为351例前庭神经切断术、135例听神经瘤切除术和14例神经血管减压术。前庭神经切断术和大多数听神经瘤手术未使用小脑牵开器。小脑牵开器已用于所有需要更好暴露颅神经根进入区的神经血管减压手术中，并应用颅内内镜进一步暴露和减压血管襻。
在后颅窝入路中，除神经血管减压术和部分听神经瘤手术外，当采用适当的患者体位、充分的麻醉技术和手术操作等条件时，无需使用小脑牵开器。
