Van Gompel Jamie J, Alikhani Puya, Youssef A Samy, Loveren Harry R van, Boyev K Paul, Agazzi Sivero
Department of Neurosurgery, Mayo Clinic, Rochester, Minnesota, United States.
Department of Neurosurgery and Brain Repair, University of South Florida, Tampa, Florida, United States.
J Neurol Surg B Skull Base. 2015 Sep;76(5):379-84. doi: 10.1055/s-0034-1543971. Epub 2015 May 13.
Objective Anterior petrosectomy(AP) was popularized in the 1980s and 1990s as micro-neurosurgery proliferated. Original reports concentrated on the anatomy of the approach and small case series. Recently, with the advent of additional endonasal approaches to the petrous apex, the morbidity of AP remains unclear. This report details approach-related morbidity around and under the temporal lobe. Methods A total of 46 consecutive patients identified from our surgical database were reviewed retrospectively. Results Of the 46 patients, 61% were women. Median age of the patients was 50 years (mean: 48 ± 2 years). Median follow-up of this cohort was 66 months. Most procedures dealt with intradural pathology (n = 40 [87%]). Approach-related morbidity consisted of only two patients (4%) with new postoperative seizures. There were only two significant postoperative hemorrhages (4%). Cerebrospinal fluid leakage occurred in two patients (4%) requiring reoperation. Conclusion Approach-related complications such as seizures and hematoma were infrequent in this series, < 4%. This report describes a contemporary group of patients treated with open AP and should serve as a comparison for approach-related morbidity of endoscopic approaches. Given the pathologies treated with this approach, the morbidity appears acceptable.
随着显微神经外科手术的普及，颞骨岩部前切除术（AP）在20世纪80年代和90年代得到广泛应用。最初的报告主要集中在该手术入路的解剖结构和小样本病例系列。近年来，随着经鼻入路到达岩尖的新方法出现，AP的发病率仍不明确。本报告详细阐述了与手术入路相关的颞叶周围及下方的发病率情况。方法：回顾性分析从我们的手术数据库中连续选取的46例患者。结果：46例患者中，61%为女性。患者的中位年龄为50岁（平均：48±2岁）。该队列的中位随访时间为66个月。大多数手术处理的是硬膜内病变（n = 40例[87%]）。与手术入路相关的发病率包括仅2例患者（4%）出现术后新发癫痫。仅有2例严重的术后出血（4%）。2例患者（4%）发生脑脊液漏，需要再次手术。结论：在本系列中，与手术入路相关的并发症如癫痫和血肿并不常见，<4%。本报告描述了一组接受开放式AP治疗的当代患者，应作为内镜手术入路相关发病率的比较。鉴于采用该手术入路治疗的病变情况，其发病率似乎是可以接受的。
