Kinjo T, Mukawa J, Tomiyama N
Department of Neurosurgery, University of the Ryukyus School of Medicine, Okinawa.
Neurol Med Chir (Tokyo). 1996 May;36(5):310-3. doi: 10.2176/nmc.36.310.
The petrosal approach has become a routine procedure for petroclival lesions, but there are some disadvantages such as the time-consuming craniotomy during surgery and depressed deformity of the mastoid area after surgery. To solve these disadvantages, we modified the petrosal approach. Before surgery, the three-dimensional points of the sigmoid sinus and semicircular canals are calculated on computed tomography scan and are input to a computer. A single temporooccipital bone flap is made, and the outer table of bone overlying the mastoid is preserved by forming a narrow groove with a small air drill and cutting the outer table with a chisel. After removing these two free bone flaps, mastoidectomy is performed guided by NEURO-SAT (neuronavigation by computer-assisted frameless stereotaxy). The mastoid bone can be drilled out safely and quickly. The two bone flaps are connected and replaced at the end of the procedure. Osteoplastic petrosal craniotomy guided by NEURO-SAT can achieve a quick craniotomy and satisfactory cosmetic result.
岩骨入路已成为处理岩斜区病变的常规手术方法，但该方法存在一些缺点，比如手术过程中开颅耗时较长，术后乳突区出现凹陷畸形。为解决这些缺点，我们对岩骨入路进行了改良。术前，在计算机断层扫描上计算乙状窦和半规管的三维点，并输入计算机。制作一块颞枕骨瓣，用小型气钻形成一条窄槽并使用凿子切割骨外板，从而保留覆盖在乳突上的骨外板。移除这两块游离骨瓣后，在神经导航系统（计算机辅助无框架立体定向神经导航）引导下进行乳突切除术。乳突骨能够安全、快速地磨除。手术结束时，将两块骨瓣连接并复位。神经导航系统引导下的骨成形性岩骨开颅术能够实现快速开颅，并获得满意的美容效果。
