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改良颞部入路治疗猫的额颞叶底部脑膜瘤

Modified temporal approach for a rostro-temporal basal meningioma in a cat.

作者信息

Forterre Franck, Jaggy André, Rohrbach Helene, Dickomeit Marc, Konar Martin

机构信息

Department of Clinical Veterinary Medicine, Division of Small Animal Surgery, Vetsuisse Faculty, University of Bern, CH-3012 Bern, Switzerland.

出版信息

J Feline Med Surg. 2009 Jun;11(6):510-3. doi: 10.1016/j.jfms.2008.11.002. Epub 2008 Dec 25.

Abstract

An 11-year-old neutered female domestic shorthair indoor cat was presented to our hospital for treatment of a left-sided rostro-temporal basal meningioma. Focal seizures in the facial muscles had been observed sporadically for 1 year. Two weeks prior to presentation the cat had developed generalised seizures and was treated with symptomatic anticonvulsive treatment. Focal facial seizures, especially on the right side, persisted after medical therapy. From the computed tomography scan, a basal meningioma was suspected by the treating veterinarian. A left-sided suprazygomatical temporobasal approach to the zygomatic arch was chosen because it causes less soft tissue damage. After craniotomy, durotomy and gentle dorsal retraction of the left piriform lobe, the meningioma was removed. Postoperative magnetic resonance imaging confirmed complete excision of the tumour. One day after surgery the cat was alert and a left-sided facial nerve palsy was noticed. Otherwise the neurological examination was normal. Anticonvulsive and eye moistening therapy was continued for 3 months. Six months after surgery the cat was clinically normal without any recurrence of seizures.

摘要

一只11岁已绝育的雌性家养短毛室内猫被送至我院,接受左侧额颞部基底脑膜瘤的治疗。面部肌肉的局灶性癫痫发作已断断续续出现1年。就诊前两周,这只猫出现了全身性癫痫发作,并接受了对症抗惊厥治疗。药物治疗后,局灶性面部癫痫发作,尤其是右侧的发作仍持续存在。经治兽医根据计算机断层扫描怀疑为基底脑膜瘤。由于该手术对软组织损伤较小,故选择了左侧经颧弓颞底部入路。开颅、硬脑膜切开并轻柔地将左侧梨状叶向背侧牵拉后,切除了脑膜瘤。术后磁共振成像证实肿瘤已完全切除。术后一天,猫警觉,发现有左侧面神经麻痹。除此之外,神经学检查正常。抗惊厥和眼部保湿治疗持续了3个月。术后6个月,猫临床正常,未出现癫痫复发。

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