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经颈静脉经岩骨入路切除三哑铃型颈静脉孔神经鞘瘤。

Transjugular transsigmoid approach for triple dumbbell-shaped jugular foramen schwannomas.

机构信息

Department of Neurosurgery, Tokyo Medical University, 6-7-1 Nishi-shinjuku, Shinjuku-ku, Tokyo, 160-0023, Japan.

出版信息

Acta Neurochir (Wien). 2019 Apr;161(4):739-743. doi: 10.1007/s00701-019-03860-1. Epub 2019 Mar 4.

Abstract

BACKGROUND

Jugular foramen tumors, particularly those that are triple dumbbell-shaped with intracranial, intraforaminal, and extracranial extensions, are difficult to access surgically. However, advances in neuroimaging, neuromonitoring, and skull base surgery have enabled their safe resection with lower rates of morbidity and mortality.

METHOD

We share our experience with the surgical technique for the management of triple dumbbell-shaped jugular foramen schwannomas.

CONCLUSION

The infralabyrinthine transjugular transsigmoid approach with high cervical exposure under continuous vagus nerve monitoring enables gross total resection of triple dumbbell-shaped jugular foramen schwannomas, aiming at surgical cure of these benign tumors for appropriately selected patients.

摘要

背景

颈静脉孔肿瘤,特别是那些具有颅内、孔内和颅外延伸的三哑铃形肿瘤,手术切除难度较大。然而,神经影像学、神经监测和颅底手术的进步使得这些肿瘤能够安全切除,并且发病率和死亡率较低。

方法

我们分享了管理三哑铃形颈静脉孔神经鞘瘤的手术技术经验。

结论

在持续迷走神经监测下进行经颅后窝经颈静脉孔乙状窦入路加高颈段显露,能够实现三哑铃形颈静脉孔神经鞘瘤的大体全切除,旨在为适当选择的患者实现这些良性肿瘤的手术治愈。

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