Department of Neurological Surgery, University of Wisconsin, Madison, Wisconsin, USA.
Neurosurg Focus. 2012 Sep;33(3):E11. doi: 10.3171/2012.7.FOCUS12208.
Of the presigmoid approaches, the translabyrinthine approach is often used when a large exposure is needed to gain access to the cerebellopontine angle but when hearing preservation is not a concern. At the authors' institution, this approach is done with the aid of ENT/otolaryngology for temporal bone drilling and exposure. In the present article and video, the authors demonstrate the use of the translabyrinthine approach for resection of a large cystic vestibular schwannoma, delineating the steps of positioning, opening, temporal bone drilling, tumor resection, and closure. Gross-total resection was achieved in the featured case. The patient's postoperative facial function was House-Brackmann Grade II on the side ipsilateral to the tumor, although function improved with time. The translabyrinthine route to the cerebellopontine angle is an excellent approach for masses that extend toward the midline or anterior to the pons. Although hearing is sacrificed, facial nerve function is generally spared.
在经迷路入路中，当需要较大的显露以进入桥小脑角但听力保护不是关注重点时，常采用该入路。在作者所在机构，该入路借助耳鼻喉科（ENT）进行颞骨钻孔和显露。在本文和视频中，作者演示了经迷路入路切除大型囊性前庭神经鞘瘤的应用，阐述了定位、切开、颞骨钻孔、肿瘤切除和闭合的步骤。在该典型病例中实现了大体全切除。尽管随着时间推移，患者面神经功能有所改善，但肿瘤侧的患侧面神经功能仍为 House-Brackmann 分级 II。对于向中线或桥前延伸的肿块，经迷路入路至桥小脑角是一种很好的方法。虽然听力丧失，但面神经功能通常得以保留。
