CAJ | 학술논문

目的探讨岩斜区脑膜瘤的最佳手术入路,以提高岩斜区肿瘤的手术疗效. 方法收集南方医科大学南方医院自2009年4月至2011年10月收治的35例累及海绵窦的岩斜区脑膜瘤患者资料进行分析,患者均采用颞下经岩骨前部入路显微外科治疗；同时选择10例20侧解剖标本进行3种改良切口模拟微创颞下经岩骨前部手术入路研究；总结患者的影像学资料、临床表现及手术疗效,结合实验标本解剖数据分析不同手术入路优缺点. 结果本组患者肿瘤全切28例,次全切6例,大部分全切1例;术后症状和体征完全消失17例,症状较术前减轻10例,颅神经损害症状同术前5例,出现新神经功能障3例.结合解剖学数据发现,3种改良切口对不同类型岩斜区肿瘤均可以达到良好的暴露. 结论颞下经岩骨前部入路是岩斜区脑膜瘤的优先选择入路.
목적 탐토암사구뇌막류적최가수술입로,이제고암사구종류적수술료효. 방법 수집남방의과대학남방의원자2009년4월지2011년10월수치적35례루급해면두적암사구뇌막류환자자료진행분석,환자균채용섭하경암골전부입로현미외과치료；동시선택10례20측해부표본진행3충개량절구모의미창섭하경암골전부수술입로연구；총결환자적영상학자료、림상표현급수술료효,결합실험표본해부수거분석불동수술입로우결점. 결과 본조환자종류전절28례,차전절6례,대부분전절1례;술후증상화체정완전소실17례,증상교술전감경10례,로신경손해증상동술전5례,출현신신경공능장3례.결합해부학수거발현,3충개량절구대불동류형암사구종류균가이체도량호적폭로. 결론 섭하경암골전부입로시암사구뇌막류적우선선택입로.
Objective To explore the microsurgical approach for petroclival tumors to improve the surgical efficacy.Methods The clinical data of 35 patients with petroclival meningiomas,underwent microsurgery through subtemporal anterior transpetrosal approach in our hospital from April 2009 to October 2011,were analyzed retrospectively.For anatomical information,the micro-neurosurgical anatomical dissection,observation and measurement were performed under microscope by mimicking the subtemporal anterior transpetrosal approach on twenty sides of ten adult formalin-fixed cadaveric heads.The advantages and disadvantages of the three approaches were compared.Results Of these 35 patients,28 received total resection of the tumors,6 subtotal resection and 1 partial resection.After the operation,the symptoms and signs disappeared in 17 patients; the symptoms got relief in 10 patients; the symptom of cranial nerve was unchanged in 5,and the new neurological disturbance appeared in 3.Good exposure could be achieved in these different types of petroclival tumors by the three approaches.Conclusion The subtemporal anterior transpetrosal approch is the best choice for patients with petroclival tumors.