我是这样做的：安全切除伴有神经血管束背侧移位的复杂 3 型枕骨大孔脑膜瘤。
How I do it: safe resection of a complex type 3 foramen magnum meningioma with dorsal displacement of the neurovascular bundle.
机构信息
Department of Neurosurgery, University of Colorado Anschutz School of Medicine, Aurora, CO, USA.
Department of Otolaryngology, University of University of Colorado Anschutz School of Medicine, Aurora, CO, USA.
出版信息
Acta Neurochir (Wien). 2024 Sep 23;166(1):376. doi: 10.1007/s00701-024-06268-8.
BACKGROUND
We describe techniques for safe resection of a Type 3 foramen magnum meningioma with dorsal displacement of the accessory nerve rootlets and vertebral artery which limits ventral access to the tumor.
METHOD
Partial sectioning of the accessory nerve rootlets may help create larger working space. Topical lidocaine placement on the rootlets of the spinal accessory nerve may mitigate trapezius muscle contraction and facilitates further progress throughout tumor resection.
CONCLUSION
Creating safe working corridors between the lower cranial nerves through mobilization or partial sectioning of rootlets in the case of CN XI facilitates tumor resection through a far lateral approach.
背景
我们描述了一种安全切除颈静脉孔 3 型脑膜瘤的技术，该肿瘤伴有神经根和椎动脉向背侧移位，这限制了肿瘤腹侧入路。
方法
部分切断副神经根可能有助于创造更大的工作空间。在颈神经根上局部使用利多卡因可以减轻斜方肌的收缩，便于在肿瘤切除过程中进一步推进。
结论
通过在颅神经 XI 情况下移动或部分切断神经根，在颅神经之间创建安全的工作通道，通过远外侧入路有利于肿瘤切除。
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