CAJ | 학술논문

目的总结原发性颈静脉孔脑膜瘤临床表现和手术治疗的特点.方法回顾性研究2004年1月至2010年10月手术治疗原发性颈静脉孔脑膜瘤患者22例,男∶女=10∶12,平均39.4岁.最常见症状是听力障碍,其次为后组脑神经症状.手术分为乙状窦-球前方、后方及联合入路.结果肿瘤全切除18例,大部切除4例.病理检查4例为WHOⅡ级,恶性(WHOⅢ级)1例.术后神经功能暂时下降,后逐渐改善.共6例肿瘤复发,其中WHOⅡ～Ⅲ级4例.仅1例恶性脑膜瘤于术后20个月死亡.结论原发性颈静脉孔脑膜瘤中非良性脑膜瘤所占比例高,虽然手术治疗取得很好效果,但仍要注意保护后组脑神经功能.
목적 총결원발성경정맥공뇌막류림상표현화수술치료적특점.방법 회고성연구2004년1월지2010년10월수술치료원발성경정맥공뇌막류환자22례,남∶녀=10∶12,평균39.4세.최상견증상시은력장애,기차위후조뇌신경증상.수술분위을상두-구전방、후방급연합입로.결과 종류전절제18례,대부절제4례.병리검사4례위WHOⅡ급,악성(WHOⅢ급)1례.술후신경공능잠시하강,후축점개선.공6례종류복발,기중WHOⅡ～Ⅲ급4례.부1례악성뇌막류우술후20개월사망.결론 원발성경정맥공뇌막류중비량성뇌막류소점비례고,수연수술치료취득흔호효과,단잉요주의보호후조뇌신경공능.
Objective To summarize the clinical manifestations,neuroimaging,surgical treatment of jugular foramen meningiomas (JFM). Methods A retrospective study of a total of 22 consecutive patients with primary JFMs treated in Beijing Tiantan hospital from January 2004 to October 2010 was performed.It included 10 male and 12 female,with average age of 39.4 ( 14 ～57 yrs).The most common symptoms was hearing disorder,followed by lower cranial nerve dysfunctions.The types of tumors included Type A (intracranial) in 15 patients,type B (intraforamen) in 1,type D (dumbell) in 6.There was no type C (extracranial).The surgical approaches were selected on tumor growth manners,including pre - sigmoid- bulb approach,retro- sigmoid- bulb,and combined that consist retrosigmoid,midline hockey- stick and postauricular C shaped incision.The surgical approaches were used in postauricular C shaped approach (pre- SBA) in 5 cases,suboccipital retrosigmoid in 7 and submidline hockey -stick in 10.Results The total resection was achieved in 18 cases,subtotal in 4.The pathological examination revealed WHO Ⅱ in 4 cases,WHO Ⅲ in one.The neurological function dropped immediately after surgery in most cases,while recovery was gained.Keeping airway patency and prevention from swallow difficulty were quite important for postoperative management.Only one patient died of tumor regrowth 20 months after the surgery for the highly malignant nature ( WHO Ⅲ ).Conclusions The surgical approaches for primary JFMs could be classified into Pre - SBA,Retro - SBA and combined approach.Non - benign meningioma is quite common at a rate about 20％.The function preservation of low cranial nerves is still challenging.