[1]池亚奇　陈鹏飞　霍显浩　王鹏远　王　睿　马亚东　田继辉.颅中、后窝三叉神经鞘瘤的分型及其治疗分析[J].中国临床神经外科杂志,2022,27(03):149-152.[doi:10.13798/j.issn.1009-153X.2022.03.002]
　CHI Ya-qi,CHEN Peng-fei,HUO Xian-hao,et al.Classification and surgical treatment of trigeminal schwannomas in middle and posterior fossas (report of 18 cases)[J].,2022,27(03):149-152.[doi:10.13798/j.issn.1009-153X.2022.03.002]
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颅中、后窝三叉神经鞘瘤的分型及其治疗分析()
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《中国临床神经外科杂志》[ISSN:1009-153X/CN:42-1603/TN]

卷:
27
期数:
2022年03期
页码:
149-152
栏目:
论著
出版日期:
2022-03-31

文章信息/Info

Title:
Classification and surgical treatment of trigeminal schwannomas in middle and posterior fossas (report of 18 cases)
文章编号:
1009-153X（2022）03-0149-03
作者:
池亚奇　陈鹏飞　霍显浩　王鹏远　王　睿　马亚东　田继辉
750004 银川，宁夏医科大学（池亚奇、陈鹏飞、霍显浩、王鹏远、王　睿、马亚东、田继辉）；750004 银川，宁夏医科大学总医院神经外科（陈鹏飞、霍显浩、田继辉 ）
Author(s):
CHI Ya-qi1;  CHEN Peng-fei2;  HUO Xian-hao1;  2;  WANG Peng-yuan1;  WANG Rui1;  MA Ya-dong1;  TIAN Ji-hui1;  2.
1. Ningxia Medical University, Yinchuan 750004, China; 2. Department of Neurosurgery, General Hospital of Ningxia Medical University, Yinchuan 750004, China
关键词:
三叉神经鞘瘤; 肿瘤分型; 显微手术; 手术入路; 疗效
Keywords:
Trigeminal schwannomas;  Tumor classification;  Microsurgery;  Surgical approach
分类号:
A
DOI:
10.13798/j.issn.1009-153X.2022.03.002
文献标志码:
R 739.41; R 651.1+1
摘要:
目的 探讨颅中、后窝三叉神经鞘瘤的分型、手术方法及其疗效。方法 回顾性分析2010~2020年手术治疗的18例颅中、后窝三叉神经鞘瘤的临床资料。按照肿瘤起源的部位分为神经节型（M型）、周围型（V型）、神经根型（P型），并根据肿瘤分型选择相应的手术入路。结果 18例中，M型10例（其中M0型1例，Mp型7例，MP型2例），P型8例（其中P0型3例，mP型5例）。12例采用颞下硬膜下经小脑幕入路（7例Mp型，1例M0型，1例P0型，3例mP型），4例采用颞下硬膜外经岩前入路（2例MP型，2例mP），2例使用枕下乙状窦后入路（P0型）。18例中，肿瘤全切除12例（其中M型8例，P型4例），部分切除6例（Mp型2例，P0型2例，mP型2例）。术后症状缓解14例，加重4例。术后随访6个月~8.5年，平均38个月；2例全切除术后复发（M型和P型各1例），4例部分切除进展，其中2例行二次手术，1例选择放疗。结论 对于颅中、后窝三叉神经鞘瘤，按照起源部位进行分型利于肿瘤的全切除，降低复发率。建议M型以及部分P型肿瘤使用颞下硬膜下经小脑幕入路，但是肿瘤发生位置多种多样，应具体情况具体分析。
Abstract:
Objective To investigate the classification and surgical outcomes of trigeminal schwannomas in the middle and posterior fossas. Methods The clinical data of 18 patients with trigeminal schwannoma in the middle and posterior fossas who underwent surgery from 2010 to 2020 were retrospectively analyzed. According to the origin of the tumor, the tumors were divided into ganglion type (M type), peripheral type (V type), and nerve root type (P type), and the corresponding surgical approach was selected according to the tumor type. Results Of these 18 patients, 10 patients were classified as M type (1 M0 type, 7 Mp type, and 2 MP type), and 8 as P type (3 P0 type and 5 mP type). The subtemporal subdural transtentorial approach was used in 12 patients including 7 Mp type, 3 mP type, 1 M0 type and 1 P0 type. The suboccipital retrosigmoid approach was used in 2 patients of P0 type. The subtemporal epidural transpetrosal approach was used in 4 patients including 2 MP type and 2 mP type. Total tumor resection was achieved in 12 patients including 8 M type and 4 P type, and partial resection in 6 patient including 2 Mp type, 2 P0 type and 2 mP type. Symptoms were relieved in 14 patients and aggravated in 4. The postoperative follow-up (range, 6 months to 8.5 years; average, 38 months) showed recurrence in 2 patients with total tumor resection (1 M type and 1 P type), and progression in 4 patients with partial tumor resection, of whom 2 patients underwent secondary surgery and 1 received radiotherapy. Conclusions For the trigeminal schwannomas in middle and posterior fossas, the classification according to the tumor origin is beneficial to the total tumor resection and reduce in the recurrence rate. It is recommended to use the subtemporal subdural transtentorial approach for M-type and P-type tumors, but the location of the tumor is varied and the surgical methods should be selected individually.

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备注/Memo

备注/Memo:
通讯作者：田继辉，E-mail：nxtjh1968@163.com
更新日期/Last Update: 1900-01-01