Goel A, Muzumdar D, Desai K
Department of Neurosurgery, King Edward VII Memorial Hospital and Seth G.S. Medical College, Parel, Mumbai, India.
Br J Neurosurg. 2006 Jun;20(3):139-45. doi: 10.1080/02688690600776796.
A retrospective analysis of 96 surgically treated tentorium and anterior tentorial hiatus-based epidermoid tumours from 1997 - 2004 is presented. The most prominent symptoms were headache (53.1%) and ataxia (44.8%). The average tumour size was 4.4 cm. Surgical approaches included posterior cranial fossa route (85 cases), basal subtemporal middle fossa route (9 cases) and combined posterior fossa and subtemporal routes in two cases. Total tumour resection was performed in 46 patients. Eight and four patients developed transient and sustained postoperative neurological deficits respectively. There was mortality in two patients. There was non-symptomatic recurrence of the tumour in two cases. Ninety-four patients are leading active functional lives. Radical and safe resection of anterior tentorium-based epidermoid tumours is associated with symptomatic relief and lasting cure. Extensive drilling of the petrous bone can be avoided. Gentle dissection of the tumour and capsule from the critical neurovascular structures can limit post-operative morbidity.
本文对1997年至2004年间96例经手术治疗的天幕及天幕裂孔前缘表皮样囊肿进行回顾性分析。最突出的症状是头痛（53.1%）和共济失调（44.8%）。肿瘤平均大小为4.4厘米。手术入路包括后颅窝入路（85例）、颞下中颅窝基底入路（9例）以及2例后颅窝与颞下联合入路。46例患者实现肿瘤全切。分别有8例和4例患者出现短暂和持续性术后神经功能缺损。2例患者死亡。2例患者肿瘤无症状复发。94例患者过着积极的功能性生活。根治性且安全地切除天幕裂孔前缘表皮样囊肿可缓解症状并实现持久治愈。可避免广泛磨除岩骨。轻柔地从关键神经血管结构上分离肿瘤及其包膜可减少术后并发症。
