[1]王栋梁 宋海栋 刘波 武广永 焦风 刘如恩*.耳后直切口锁孔显微手术治疗桥小脑角区肿瘤[J].中国微创外科杂志,2020,01(1):42-45.
　Wang Dongliang,Song Haidong,Liu Bo,et al.Microsurgical Resection of Tumors in Cerebellar Pontine Angle Area by Straight Incision Behind the Ear and "Keyhole" Approach[J].Chinese Journal of Minimally Invasive Surgery,2020,01(1):42-45.
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耳后直切口锁孔显微手术治疗桥小脑角区肿瘤()
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《中国微创外科杂志》[ISSN:1009-6604/CN:11-4526/R]

卷:
01
期数:
2020年1期
页码:
42-45
栏目:
临床研究
出版日期:
2020-03-25

文章信息/Info

Title:
Microsurgical Resection of Tumors in Cerebellar Pontine Angle Area by Straight Incision Behind the Ear and "Keyhole" Approach
作者:
王栋梁 宋海栋 刘波 武广永 焦风 刘如恩*
（北京大学人民医院神经外科，北京100044）
Author(s):
Wang Dongliang;  Song Haidong;  Liu Bo;  et al.
Department of Neurosurgery, Peking University People’s Hospital, Beijing 100044, China
关键词:
直切口; 锁孔; 桥小脑角区肿瘤
Keywords:
Straight incision; Keyhole; Tumor in cerebellar pontine angle area
文献标志码:
A
摘要:
目的探讨耳后直切口锁孔显微手术切除桥小脑角（cerebellar pontine angle，CPA）区肿瘤的安全性。方法2017年1月~2019年4月我科对52例CPA区肿瘤采用耳后直切口锁孔，经乙状窦后入路，在显微镜下切除肿瘤，硬膜间断缝合后用人工硬膜覆盖，小骨瓣复位，术中全程行面、三叉神经和前庭蜗神经电生理监测。结果肿瘤全切除50例（962%），次全切除1例（1.9%），1例表皮样囊肿因向鞍区生长，一期行翼点开颅全切肿瘤。26例听神经瘤面神经功能保留率61.5%（16/26）。26例听神经瘤术前尚存在听力20例，术后听力保留10例；其余26例术后听力下降3例（11.5%）。52例随访3~31个月，中位数16个月，无肿瘤复发，无新发并发症。结论耳后直切口锁孔切除CPA区肿瘤安全可行、微创，值得推广。
Abstract:
ObjectiveTo explore the safety of microsurgical resection of tumors in cerebellar pontine angle (CPA) area by straight incision behind the ear and "keyhole" retrosigmoid approach.MethodsFrom January 2017 to April 2019, 52 cases of CPA area tumors were treated through the straight incision behind the ear and "keyhole" retrosigmoid approach. The tumor was resected under the microscope, then the dura was sutured intermittently and covered with artificial dura mater, followed with reduction of small bone flap. During the operation, the facial nerve, trigeminal nerve and vestibular cochlear nerve were monitored.ResultsTotal tumor resection were performed in 50 cases (96.2%), and subtotal resection in 1 case (19%). One case of epidermoid cyst was given firststage of pterional craniotomy because of the growth towards the sellar region. The preservation rate of facial nerve anatomy was 61.5% (16/26). In 26 cases of acoustic neuroma, there were 20 cases of hearing before operation, 10 cases of hearing retention after operation. There were 3 cases (11.5%) of hearing loss after operation in the remaining 26 cases. 52 cases were followed up for 3-31 months (median, 16 months). No tumor recurrence and new complications were found.ConclusionThe resection of tumors in CPA area by straight incision behind the ear and "keyhole" approach is safe, feasible and minimally invasive, which is worthy of promotion.

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备注/Memo

备注/Memo:
*通讯作者，Email：liure@126.com
更新日期/Last Update: 2020-04-16