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经斜直切口远外侧入路手术治疗枕骨大孔区肿瘤:病例系列报告及技术说明

Surgical management of a foramen magnum tumor via a far-lateral approach using an oblique straight incision: a case series report and technique note.

作者信息

Bai Jie, Jian Zhi-Heng, Chen Peng, Cheng Ye, Wang Ya-Ming, Chen Gang, Xiao Xin-Ru

机构信息

Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, China.

Department of Nenrosurgery, Zhuhai's People Hospital (Zhuhai Clinical Medical College of Jinan University), Zhuhai, China.

出版信息

Front Oncol. 2024 Jun 12;14:1391002. doi: 10.3389/fonc.2024.1391002. eCollection 2024.

Abstract

OBJECTIVE

To review our single-institution experience in the surgical management of foramen magnum tumors via a far-lateral approach using an oblique straight incision.

METHODS

From October 2023 to January 2024, four cases of tumors in the foramen magnum area treated at the Capital Medical University-affiliated XuanWu hospital neurosurgery department were involved in this study. All cases were managed with a far-lateral approach using an oblique straight incision. We retrospectively reviewed the clinical and imaging data, as well as the surgical strategies employed.

RESULTS

Three cases of foramen magnum meningiomas and one case of glioma of the ventral medulla. All cases underwent a far-lateral approach using an oblique straight incision; all cases had a gross total resection, and the wounds healed well without cerebral fluid leakage or scalp hydrops. Except for one case of right foramen magnum meningioma, which had dysphagia and pneumothorax, the other cases were without any postoperative complications.

CONCLUSION

A far-lateral approach using an oblique straight incision can preserve muscle integrity and minimize subcutaneous exposure, allowing for complete anatomical reduction of muscles. This craniectomy method is simple and replicable, making it worthy of further clinical practice.

摘要

目的

回顾我们单机构采用斜直切口经远外侧入路手术治疗枕大孔区肿瘤的经验。

方法

2023年10月至2024年1月,首都医科大学附属宣武医院神经外科收治的4例枕大孔区肿瘤患者纳入本研究。所有病例均采用斜直切口经远外侧入路进行治疗。我们回顾性分析了临床和影像学资料以及所采用的手术策略。

结果

3例枕大孔区脑膜瘤,1例延髓腹侧胶质瘤。所有病例均采用斜直切口经远外侧入路;所有病例均实现肿瘤全切除,伤口愈合良好,无脑脊液漏或头皮积液。除1例右侧枕大孔区脑膜瘤患者出现吞咽困难和气胸外,其他病例均无术后并发症。

结论

采用斜直切口经远外侧入路可保持肌肉完整性,减少皮下暴露,实现肌肉的完全解剖复位。这种开颅方法简单且可重复,值得进一步临床实践。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/94d7/11200113/120f33ad85a4/fonc-14-1391002-g001.jpg

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