Kamitani H, Masuzawa H, Kanazawa I, Kubo T, Tokuyama Y
Department of Neurosurgery, Kanto Teishin Hospital, Tokyo, Japan.
Acta Neurochir (Wien). 1994;126(2-4):179-84. doi: 10.1007/BF01476430.
An approach which improves on the conventional suboccipital craniectomy was used to explore a jugular foramen, a hypoglossal neurinoma, and a tentorial meningioma. A postero-medial mastoidectomy supplemented by the conventional suboccipital craniectomy made it possible to expose the entire sigmoid sinus. Subsequent medial retraction of the exposed sigmoid sinus and continuous dura mater and the extradural removal of petrous bone around the jugular foramen exposed the whole extracranial portion of the tumours. The tumours were totally removed by this approach in which the extradural route corresponded to the extracranial portion of the tumours and the suboccipital route to the intracranial portion. Facial nerve and hearing disturbances, which are frequent complications of the previous approaches, did not occur in our cases. Providing adequate exposure with simple surgical procedures and showing no adverse postoperative sequelae, this approach is most suitable for surgery upon jugular foramen tumours with extracranial extension.
采用一种改进的传统枕下颅骨切除术来探查颈静脉孔、舌下神经鞘瘤和小脑幕脑膜瘤。通过后内侧乳突切除术并辅以传统枕下颅骨切除术，得以暴露整个乙状窦。随后将暴露的乙状窦及连续的硬脑膜向内侧牵拉，并在颈静脉孔周围硬膜外切除颞骨，从而暴露肿瘤的整个颅外部分。通过这种方法，肿瘤被完全切除，其中硬膜外路径对应肿瘤的颅外部分，枕下路径对应肿瘤的颅内部分。我们的病例未出现先前手术方法常见的面神经和听力障碍等并发症。该方法通过简单的手术操作提供了充分的暴露，且未显示出不良的术后后遗症，最适合用于有颅外扩展的颈静脉孔肿瘤手术。
