Bilgin Emre, Çavus Gökhan, Açik Vedat, Arslan Ali, Olguner Semih Kivanç, Istemen Ismail, Gezercan Yurdal, Ökten Ali Ihsan
Adana City Training and Research Hospital, Neurosurgery Clinic, Adana, Turkey.
Pan Afr Med J. 2019 Sep 3;34:5. doi: 10.11604/pamj.2019.34.5.17536. eCollection 2019.
We aimed to discuss surgical approaches and results that we applied foramen magnum meningiomas.
We retrospectively investigated 11 foramen magnum meningioma cases, who had been operated between the dates of February 2012 and March 2017.
Eight of the patients were females and 3 of the patients were males, the age range was 32-75 and the age average was 60.8. 5 of the tumors were anatomically localized as posterolateral, 2 of them were localized as anterolateral, 2 of them were localized as lateral and 2 of them were localized as anterior according to the brain stem or spinal cord. Posterior far lateral (4 patients) approach including C1 laminoplasty (7 patients) and 1/3 condyle resection was surgically applied to the patients with median suboccipital craniotomy. Gross total excision was applied to 82% of the patients (9 patients) and subtotal mass excision was applied to 18% (2 patients) of the patients. The most frequent post-operative complications were temporary lower cranial nerve (CN IX and X ) palsy in our 2 anterior localized cases (18%) and also cerebrospinal fluid (CSF) fistula in our 1 anterior localized case with difficulty in swallowing (dysphagia). Karnofsky scores of the patients, who were followed for 18 months in post-operative 12 and 48 months of average, in the last follow-up were 80 and no post-operative mortality occurred.
Posterior midline suboccipital and far lateral approaches that we apply in our own series were appropriate approaches for foramen magnum meningiomas.
我们旨在探讨应用于枕骨大孔脑膜瘤的手术方法及结果。
我们回顾性研究了2012年2月至2017年3月期间接受手术的11例枕骨大孔脑膜瘤病例。
患者中8例为女性，3例为男性，年龄范围为32 - 75岁，平均年龄为60.8岁。根据与脑干或脊髓的关系，5例肿瘤位于后外侧，2例位于前外侧，2例位于外侧，2例位于前方。对患者采用后外侧远外侧入路（4例患者），包括C1椎板成形术（7例患者）和1/3髁突切除术，并行枕下正中开颅手术。82%（9例患者）的患者实现了肿瘤全切，18%（2例患者）的患者进行了次全切除。最常见的术后并发症是2例位于前方的患者出现暂时性低位颅神经（IX和X）麻痹（18%），以及1例位于前方且伴有吞咽困难的患者出现脑脊液漏。术后平均随访12个月和48个月，随访18个月时患者的卡氏评分（Karnofsky scores）为80分，且无术后死亡病例。
我们系列研究中应用的枕下后正中及远外侧入路是治疗枕骨大孔脑膜瘤的合适方法。
