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经乙状窦后和中颅窝联合入路切除小型、上斜坡脑膜瘤：我的经验分享

Combined retrosigmoid and middle fossa approach for a small, superiorly located petroclival meningioma: how I do it.

机构信息

Department of Neurosurgery, Clinical Neurosciences Center, University of Utah, 175 N. Medical Drive East, Salt Lake City, UT, 84132, USA.

出版信息

Acta Neurochir (Wien). 2023 Oct;165(10):2931-2935. doi: 10.1007/s00701-023-05775-4. Epub 2023 Aug 29.

DOI:10.1007/s00701-023-05775-4
PMID:37642691
Abstract

BACKGROUND

Petroclival meningiomas pose significant surgical challenges because of their deep location and complex surrounding neurovasculature. The use of multiple surgical approaches can optimize safe tumor removal from multiple anatomic compartments.

METHOD

We describe a patient with a growing superior petroclival meningioma centered at the posterior clinoid with extension into Meckel's cave that was successfully removed with a combined retrosigmoid and subtemporal middle fossa approach. This strategy avoided the need for anterior petrous bone drilling and tentorial splitting.

CONCLUSION

A combined retrosigmoid and subtemporal middle fossa approach can provide safe access to tumors spanning the supra- and infratentorial compartments.

摘要

背景

由于位置深、周围神经血管结构复杂，岩斜脑膜瘤的手术极具挑战性。采用多种手术入路可从多个解剖部位安全切除肿瘤。

方法

我们描述了 1 例患者，其生长于岩斜区的大型蝶骨嵴内上型脑膜瘤，向鞍旁及岩斜区延伸，通过联合乙状窦后入路和颞下入路成功切除。这种策略避免了经岩骨前部钻孔和切开天幕。

结论

联合乙状窦后入路和颞下入路可安全到达跨越幕上和幕下间隙的肿瘤。

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Combined retrosigmoid and middle fossa approach for a small, superiorly located petroclival meningioma: how I do it.经乙状窦后和中颅窝联合入路切除小型、上斜坡脑膜瘤：我的经验分享
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本文引用的文献

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Petroclival meningiomas: the risk of post-operative cranial nerve deficits among different surgical approaches-a systematic review and meta-analysis.岩斜脑膜瘤：不同手术入路术后颅神经损伤风险的系统评价和荟萃分析。
Acta Neurochir (Wien). 2020 Sep;162(9):2135-2143. doi: 10.1007/s00701-020-04395-6. Epub 2020 May 18.
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Treatment Strategy for Petroclival Meningiomas Based on a Proposed Classification in a Study of 168 Cases.基于 168 例研究提出的分类的岩斜脑膜瘤治疗策略。
Sci Rep. 2020 Mar 13;10(1):4655. doi: 10.1038/s41598-020-61497-y.
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The retrosigmoid approach to petroclival meningioma surgery.
乙状窦后入路岩斜区脑膜瘤切除术。
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Combined subtemporal and retrosigmoid keyhole approach for extensive petroclival meningiomas surgery: report of experience with 7 cases.颞下和乙状窦后联合锁孔入路治疗大型岩斜区脑膜瘤手术：7例经验报告
Minim Invasive Neurosurg. 2008 Apr;51(2):95-9. doi: 10.1055/s-2007-1022551.
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Evolution of surgical approaches in the treatment of petroclival meningiomas: a retrospective review.岩斜区脑膜瘤治疗中手术入路的演变：一项回顾性研究
Neurosurgery. 2007 Nov;61(5 Suppl 2):202-9; discussion 209-11. doi: 10.1227/01.neu.0000303218.61230.39.
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Working area and angle of attack in three cranial base approaches: pterional, orbitozygomatic, and maxillary extension of the orbitozygomatic approach.三种颅底入路的工作区域和入射角：翼点入路、眶颧入路以及眶颧入路的上颌扩展入路。
Neurosurgery. 2002 Mar;50(3):550-5; discussion 555-7.
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Suprameatal extension of the retrosigmoid approach: microsurgical anatomy.乙状窦后入路的颞上延伸：显微外科解剖学
Neurosurgery. 1999 Mar;44(3):553-60. doi: 10.1097/00006123-199903000-00065.
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Transpetrosal and combination approaches to skull base lesions.经颞骨岩部及联合入路治疗颅底病变。
Clin Neurosurg. 1996;43:91-112.
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