CAJ | 학술논문

目的探讨单纯内镜经鼻入路切除颞下窝硬膜外三叉神经鞘瘤的可行性.方法 2004年11月至2009年7月采用单纯内镜经鼻入路对8例颞下窝硬膜外三叉神经鞘瘤(Jefferson's D型)患者实施了外科治疗.男性4例,女性4例,年龄31～62岁,平均27.6岁.其中,面部麻木6例,头痛3例,视力减退3例,听力减退3例,画部感觉障碍2例,咀嚼肌运动障碍并萎缩1例,鼻塞1例,牙痛1例,耳鸣1例,嗅觉障碍1例.术后定期随访,复查MRI.结果 8例患者均为完全切除(全切除率100%),手术时间40～120 min,术中出血300～1500 ml,平均出血量为543.8 ml.术后5例患者切除肿瘤后有鞍旁及颞下颅底骨质缺损,在3.0 cm×2.5 cm左右.术后患者头痛症状均消失,4例患者面部麻木无明显改善,2例术前有视力减退患者术后视力恢复.未见术中及术后并发症.术后随访10～65个月无复发病例.结论内镜经鼻入路可以完全切除侵犯颞下窝硬膜外的三叉神经鞘瘤,该入路具有简便、视觉效果好、微侵袭和并发症少等特点,并能够获得良好的预后.
목적 탐토단순내경경비입로절제섭하와경막외삼차신경초류적가행성.방법 2004년11월지2009년7월채용단순내경경비입로대8례섭하와경막외삼차신경초류(Jefferson's D형)환자실시료외과치료.남성4례,녀성4례,년령31～62세,평균27.6세.기중,면부마목6례,두통3례,시력감퇴3례,은력감퇴3례,화부감각장애2례,저작기운동장애병위축1례,비새1례,아통1례,이명1례,후각장애1례.술후정기수방,복사MRI.결과 8례환자균위완전절제(전절제솔100%),수술시간40～120 min,술중출혈300～1500 ml,평균출혈량위543.8 ml.술후5례환자절제종류후유안방급섭하로저골질결손,재3.0 cm×2.5 cm좌우.술후환자두통증상균소실,4례환자면부마목무명현개선,2례술전유시력감퇴환자술후시력회복.미견술중급술후병발증.술후수방10～65개월무복발병례.결론 내경경비입로가이완전절제침범섭하와경막외적삼차신경초류,해입로구유간편、시각효과호、미침습화병발증소등특점,병능구획득량호적예후.
Objective To investigate the feasibility of removing extracranial trigeminal chawnnomas located in the infratemporal fossa by using a purely endoscopic endonasal approache. Methods From November 2004 to July 2009, 8 patients with extracranial trigeminal schawnnomas located in the infratemporal fossa (4 male patients and 4 female patients, age ranged 31-62 years)were surgically treated by using a purely endoscopic endonasal approache. Results The maximum diameters of the tumors ranged from 3 to 7 cm. All tumors were completely removed. The operation time was 40 to 120 min,blood loss was 300 to 1500 ml. The clinical symptoms of some patients were relieved or improved. There were no intraoperative and postoperative complications, no deaths in this series. No relapse happened during the follow-up. Conclusions The purely endoscopic endonasal approach may provide a minimally invasive and safe approach to remove extracranial trigeminal schawnnomas extending into the infratemporal fossa. Radical resection is associated with an excellent long-term outcome in this series.