Department of Neurosurgery, Chinese Academy of Medical Sciences, Beijing, China.
J Craniomaxillofac Surg. 2012 Jun;40(4):354-61. doi: 10.1016/j.jcms.2011.05.012. Epub 2011 Jul 5.
Triple dumbbell-shaped jugular foremen schwannomas (DSJFSs) have high cervical extension according to Bulsara's classification. One-stage, single-discipline, total removal of triple DSJFSs is not always possible due to their both intracranial and cervical extensions. We evaluated our experience in one-stage resection of triple DSJFSs by using a combined neurosurgical and head and neck approach.
Between October 2004 and May 2009, eight patients with triple DSJFSs were treated surgically at our institute. The clinical and radiological features, operative procedures and outcomes are retrospectively reviewed.
Total tumour removal was achieved in seven patients and near total in one. New cranial nerve (CN) paresis occurred after surgery in one patient and worsening of preoperative CN deficits was noted in three. Two patients experienced cerebrospinal fluid leakage and one of them had a repeated operation with closure of the dural deficit. Follow-up period ranged from 23 to 60 months (mean 38 months). All CN dysfunction had improved considerably at the last follow-up examination. There have been no clinical or radiological signs of tumour recurrence.
One-stage total resection of triple DSJFSs can be achieved by a multidisciplinary cranial base team composed of neurosurgeons and head and neck surgeons via a craniocervical approach.
根据 Bulsara 的分类，三哑铃形颈静脉孔神经鞘瘤（DSJFS）具有较高的颈椎延伸。由于其颅内和颈椎的延伸，并非总是可以进行一期、单一学科、完全切除三重 DSJFS。我们通过联合神经外科和头颈部入路评估了一期切除三重 DSJFS 的经验。
2004 年 10 月至 2009 年 5 月，我院收治了 8 例三哑铃形颈静脉孔神经鞘瘤患者。回顾性分析其临床和影像学特征、手术过程和结果。
7 例患者肿瘤全切除，1 例近全切除。1 例患者术后出现新的颅神经（CN）麻痹，3 例患者术前 CN 缺损加重。2 例患者发生脑脊液漏，其中 1 例再次手术，硬膜缺损闭合。随访时间为 23 至 60 个月（平均 38 个月）。所有 CN 功能障碍在最后一次随访检查时均有明显改善。无肿瘤复发的临床或影像学迹象。
由神经外科医生和头颈部外科医生组成的颅底多学科团队通过颅颈入路可实现三重 DSJFS 的一期全切除。
