岩斜区脑膜瘤的锁孔入路手术
Keyhole approach surgery for petroclival meningioma.
作者信息
Zhu Wei, Mao Ying, Zhou Liang-fu, Zhang Rong, Chen Liang
机构信息
Department of Neurosurgery, Shanghai Neurosurgical Center, Huashan Hospital of Fudan University, Shanghai 200040, China.
出版信息
Chin Med J (Engl). 2006 Aug 20;119(16):1339-42.
BACKGROUND
In China, the feasibility of keyhole approach in surgical treatment of petroclival meningioma has not been well evaluated. This report summarized our experience in 25 patients with petroclival meningioma who had been treated with keyhole approach surgery.
METHODS
From July 2000 to July 2005, 25 patients with petroclival meningioma were subjected to resection via subtemporal, retrosigmoid or combined keyhole approaches. The extent of tumor resection was evaluated by MRI 3 months after surgery, and postoperative complications were investigated.
RESULTS
The maximum diameter of tumors ranged from 2 to 7 cm (mean, 4.5 cm). Gross total resection (GTR) was achieved in 14 patients, giving a GTR rate of 56%. Subtotal resection (STR) was carried out in 8 patients and partial resection in 3. Thirteen patients kept normal neurological status, whereas others suffered from cranial nerve deficits (VII, VII, III and lower CN). One patient died in the postoperative period.
CONCLUSIONS
Keyhole approach surgery, especially the combined keyhole approach is suitable for the treatment of petroclival meningioma. It provides easy and quick access to the supra- and infratentorial juxta-clival region without drilling of the petrous bone. Complications related to the approach can be minimized.
背景
在中国，锁孔入路手术治疗岩斜区脑膜瘤的可行性尚未得到充分评估。本报告总结了我们应用锁孔入路手术治疗25例岩斜区脑膜瘤患者的经验。
方法
2000年7月至2005年7月，25例岩斜区脑膜瘤患者接受了经颞下、乙状窦后或联合锁孔入路的肿瘤切除术。术后3个月通过MRI评估肿瘤切除范围，并调查术后并发症。
结果
肿瘤最大直径为2至7厘米（平均4.5厘米）。14例患者实现了全切除（GTR），全切除率为56%。8例患者进行了次全切除（STR），3例患者进行了部分切除。13例患者神经功能状态正常，其他患者出现颅神经功能缺损（VII、VII、III和低位颅神经）。1例患者术后死亡。
结论
锁孔入路手术，尤其是联合锁孔入路适用于岩斜区脑膜瘤的治疗。它无需磨除岩骨即可轻松快速地到达幕上和幕下近斜坡区域。与该入路相关的并发症可降至最低。
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