Department of Neurosurgery, Tokyo Medical University, Tokyo, Japan.
Neurosurg Focus. 2017 Oct;43(VideoSuppl2):V3. doi: 10.3171/2017.10.FocusVid.17290.
Surgical management of cerebellopontine angle meningiomas is challenging due to the intricate neurovascular structures within the limited operative field and the compression of eloquent structures including the brainstem. Surgery on tumors extending into the temporal bone is especially difficult and demands complicated approaches. However, modifications to the retrosigmoid approach utilizing intradural temporal bone drilling enable access to such tumoral extensions without any additional invasive approaches. This video demonstrates the case of a cerebellopontine angle meningioma extending into the internal acoustic meatus and jugular foramen that was surgically treated through the retrosigmoid transmeatal and suprajugular approaches under continuous vagus nerve monitoring. The video can be found here: https://youtu.be/aUD1vr6TbOc .
由于小脑脑桥角神经血管结构复杂，手术操作空间有限，并且存在脑干等重要结构受压，因此该部位脑膜瘤的手术治疗极具挑战性。对于延伸至颞骨的肿瘤，手术难度更大，需要采用复杂的入路方法。然而，通过在乙状窦后入路中进行硬脑膜内颞骨钻孔，可以在不增加任何额外侵袭性入路的情况下，到达这些肿瘤的延伸部位。本视频演示了一例延伸至内听道和颈静脉孔的小脑脑桥角脑膜瘤，该肿瘤通过乙状窦后经外耳道和上颈静脉联合入路，在持续迷走神经监测下进行手术治疗。视频可在此处查看：https://youtu.be/aUD1vr6TbOc。
