Dorland P, Sterkers J M, Renou G, Corlieu P
Rev Neurol (Paris). 1978 Jun-Jul;134(6-7):443-52.
It is well-known today that there is a cisternal "no man's land" between the petrous bone and the cerebral trunk in which a tumour can develop insidiously. The clinical signs are very variable and often in contradiction with those described for larger tumours. Tomodensimetry is indicated, but it is not conclusive if the mass is limited to the internal auditory canal or if it extends into the angle for less than 15 mm. Opaque meato-cisternography alone, gives the following information: 1. When a pseudo-tumoural syndrome is present, the auditory canal and cisterna are well opacified. 2. If there is a tumour which extends for more than 20 mm into the cisterna, the oil has a rounded, interrupted contour, and other radiological examinations are useful in this case. 3. When the tumour extends for less than 20 mm into the angle a rounded continuous contour is seen, and Hirtz's axial incidence can be used to measure the tumour diameter. 4. Finally, when temporary opacification faults have been eliminated (after retilting), opaque meato-cisternography is the only examination able to demonstrate the early stages of a tumour, in the intra-canal stage. This early diagnostic procedure has enabled one of us to excise tumours of moderate of even very small volume, under the best surgical conditions, and with functional and vital results which we would not have obtained at a later date.
如今众所周知,在岩骨与脑干之间存在一个脑池“无人区”,肿瘤可在此隐匿性生长。临床症状变化很大,且常常与较大肿瘤所描述的症状相矛盾。需要进行体层摄影测量,但如果肿块局限于内耳道或其向脑池角的延伸小于15毫米,则结果不具有决定性意义。单独的不透明中耳脑池造影可提供以下信息:1. 当出现假肿瘤综合征时,耳道和脑池显影良好。2. 如果存在一个向脑池延伸超过20毫米的肿瘤,油剂会呈现圆形、中断的轮廓,此时其他放射学检查会很有用。3. 当肿瘤向脑池角的延伸小于20毫米时,会看到圆形连续轮廓,可利用希尔茨轴位投照来测量肿瘤直径。4. 最后,当消除了暂时性显影缺陷(重新倾斜后),不透明中耳脑池造影是唯一能够显示肿瘤在管内期早期阶段的检查。这种早期诊断方法使我们中的一人能够在最佳手术条件下切除中等大小甚至非常小的肿瘤,并取得了我们在更晚阶段无法获得的功能和生命预后结果。