CAJ | 학술논문

目的探讨经颞下岩骨前方入路切除岩斜区脑膜瘤的疗效.方法 2012年1月至2014年6月南昌大学第二附属医院神经外科采用颞下岩骨前方入路切除内听道以内、桥延沟以上累及中后颅窝的岩斜区脑膜瘤23例,回顾性分析其术后疗效.结果 23例患者中,肿瘤全切除16例(Simpson Ⅰ～Ⅱ级),次全切除7例(SimpsonⅣ级),无死亡病例.随访3～ 24个月,1例次全切除的患者肿瘤稍增大.术前症状明显的20例患者,术后13例得到改善.术后出现的短暂性神经功能障碍包括,动眼神经麻痹1例、吞咽困难1例、面瘫4例、颜面部麻木4例、复视2例、对侧肢体活动障碍2例;随访期内症状未见明显改善的有动眼神经麻痹1例、耳聋4例、颜面部麻木2例、眼内斜2例.结论经颞下岩骨前方入路切除内听道以内、桥延沟以上累及中后颅窝的岩斜区脑膜瘤具有一定优势,尽管术后部分患者出现神经功能障碍,但大多数是轻度、可逆、可接受的.
목적 탐토경섭하암골전방입로절제암사구뇌막류적료효.방법 2012년1월지2014년6월남창대학제이부속의원신경외과채용섭하암골전방입로절제내은도이내、교연구이상루급중후로와적암사구뇌막류23례,회고성분석기술후료효.결과 23례환자중,종류전절제16례(Simpson Ⅰ～Ⅱ급),차전절제7례(SimpsonⅣ급),무사망병례.수방3～ 24개월,1례차전절제적환자종류초증대.술전증상명현적20례환자,술후13례득도개선.술후출현적단잠성신경공능장애포괄,동안신경마비1례、탄인곤난1례、면탄4례、안면부마목4례、복시2례、대측지체활동장애2례;수방기내증상미견명현개선적유동안신경마비1례、이롱4례、안면부마목2례、안내사2례.결론 경섭하암골전방입로절제내은도이내、교연구이상루급중후로와적암사구뇌막류구유일정우세,진관술후부분환자출현신경공능장애,단대다수시경도、가역、가접수적.
Objective To investigate the efficacy of resection of petroclival meningiomas via modified subtemporal anterior transpetrosal approach.Methods Twenty-three patients with petroclival meningioma within the internal auditory canal and above the bridge grike resected by using the modified subtemporal anterior transpetrosal approach at the Department of Neurosurgery, the Second Affiliated Hospital of Nanchang University from January 2012 to June 2014 were analyzed retrospectively.Results None of the 23 patients died in this group.The tumors of 16 patients were totally resected (Simpson's classification, grade Ⅰ-Ⅱ) and those of 7 patients were subtotally resected (Simpson's classification,grade Ⅳ).They were followed up for 3 to 24 months.The tumor of 1 patient with subtotal resection increased slightly.Of the 20 patients with obvious symptoms before procedure, 13 were improved after procedure.They had transient neurological deficit after procedure, including 1 with oculomotor nerve palsy, 1 with dysphagia, 4 with facial paralysis, 4 with facial numbness, 2 with diplopia, and 2 with contralateral limb movement disorder.The symptoms were not improved significantly during follow-up period, including 1 with oculomotor nerve palsy, 4 with deafness, 2 with facial numbness, and 2 with esotropia.Conclusions Resection of petroclival meningiomas within the internal auditory canal and above the bridge grike via subtemporal anterior transpetrosal approach has certain advantages.Although some patients have neurological deficits after procedure, most of them are mild, reversible, and acceptable.