[1]张治元 王汉东 樊友武 潘云曦 董国俊.桥小脑角区脑膜瘤的分型及显微外科治疗[J].中国临床神经外科杂志,2019,(03):132-134.[doi:10.13798/j.issn.1009-153X.2019.03.002]
 ZHANG Zhi-yuan,WANG Han-dong,FAN You-wu,et al.Classification and microsurgical treatment of cerebellopontine angle meningiomas[J].,2019,(03):132-134.[doi:10.13798/j.issn.1009-153X.2019.03.002]
点击复制

桥小脑角区脑膜瘤的分型及显微外科治疗()
分享到:

《中国临床神经外科杂志》[ISSN:1009-153X/CN:42-1603/TN]

卷:
期数:
2019年03期
页码:
132-134
栏目:
论著
出版日期:
2019-03-20

文章信息/Info

Title:
Classification and microsurgical treatment of cerebellopontine angle meningiomas
文章编号:
1009-153X(2019)03-0132-03
作者:
张治元 王汉东 樊友武 潘云曦 董国俊
作者单位:210002 南京,中国人民解放军东部战区总医院暨南京大学医学院南京金陵医院神经外科(张治元、王汉东、樊友武、潘云曦、董国俊)
Author(s):
ZHANG Zhi-yuan WANG Han-dong FAN You-wu PAN Yun-xi DONG Guo-jun.
Department of Neurosurgery, Nanjing Jinling Hospital, Nanjing 210002, China
关键词:
脑膜瘤桥小脑角区手术入路显微手术
Keywords:
Meningioma Cerebellopontine angle Operative approach Microsurgery Classification
分类号:
R 739.41; R 651.1+1
DOI:
10.13798/j.issn.1009-153X.2019.03.002
文献标志码:
A
摘要:
目的 探讨桥小脑角区脑膜瘤的分型及显微外科治疗。方法 回顾性分析2008年6月至2017年3月收治的76例桥小脑角区脑膜瘤的临床资料,根据术前检查及术中判断分为内听孔前型31例,内听孔后型17例,大型联合型28例。73例采用枕下乙状窦后入路,2例使用颞下入路,1例使用翼点入路。结果 肿瘤全切除71例,次全切除5例。术后随访1~10年,术后新增神经症状15例,其余病人术后症状均改善;复查头颅MRI,复发3例;死亡2例。结论 显微手术切除桥小脑角区脑膜瘤可获得满意效果及良好预后;扩大枕下乙状窦后入路可满足绝大多数桥小脑角区脑膜瘤切除的需要;颅神经、岩静脉及重要动脉的保护和处理在桥小脑角区脑膜瘤显微外科治疗中具有重要意义。
Abstract:
Objective To investigate the classification and microsurgical treatment of the cerebellopontine angle (CPA) meningiomas. Methods The clinical data of 76 patients with CPA meningiomas undergoing microsurgery from June, 2008 to March, 2017 were analyzed retrospectively. The different approaches of the microsurgery performed in the patients were selected according to the classification of CPA meningiomas. Of 76 CPA meningiomas, 31 were premeatal type tumors, 17 postmeatal type and 28 combined types according to the tumorous relationship with the internal acoustic canal. Of 76 patients with CPA meningiomas, 73 underwent microsurgery through subocipital retrosigmoid approach, 2 through subtemporal approach and 1 through pterional approach. The patients were followed up for 1 to 10 years. Results The CPA meningiomas were totally resected in 71 patients and partially in 5. Two patients died and there were new neurological dysfunctions in 15 patients during the following up. Conclusions The curative effects of microsurgery on CPA meningiomas are good. The microsurgery through the extended suboccipital retrosigmoid approach for almost CPA meningiomas is preferable. It is important to separate and protect various cranial nerves, venae petrosa and important arteries in the microsurgical operation of CPA meningiomas.

参考文献/References:


[1] 杨静波,李仕广. 桥小脑角区脑膜瘤与内听道及颅神经关系的MRI特征分析[J]. 中国临床神经外科杂志,2015,20(3):172-174.
[2] Tan LA, Gerard CS, Ahuja SK, et al. Retrosigmoid approach for resection of cerebellopontine angle meningioma and decompression of the trigeminal nerve [J]. Neurosurg Focus, 2014, 36(1 Suppl): 1-1.
[3] Yoshino M, Kin T, Nakatomi H, et al. Presurgical planning of feeder resection with realistic three-dimensional virtual operation field in patient with cerebellopontine angle men-ingioma [J]. Acta Neurochir (Wien), 2013, 155(8): 1391-1399
[4] 黄冠又,张俊廷,吴 震,等. 小脑脑桥角脑膜瘤显微外科治疗及面听神经保护[J]. 中华神经外科杂志,2012,28(7):674-677.
[5] Kunii N, Ota T, Kin T, et al. Angiographic classification of tumor attachment of meningiomas at the cerebellopontine angle [J]. World Neurosurg, 2011, 75(1): 114-121.
[6] Roche PH, Regis J. Cerebellopontine angle meningiomas [J].J Neurosurg, 2005, 103 (5) : 935-937.
[7] Bassiouni H, Hunold A, Asgari S, et al. Meningiomas of the posterior petrous bone: functional outcome after microsur-gery [J]. J Neurosurg, 2004, 100(6): 1014-1024.
[8] Wu ZB, Yu CJ, Guan SS, et al. Posterior petrous meningio-mas: 82 cases [J]. J Neurosurg, 2005, 102(2): 284-289.
[9] Baroncini M, Thines L, Reyns N, et al. Retrosigmoid ap-proach for meningiomas of the cerebellopontine angle: results of surgery and place of additional treatments [J]. Acta Neurochir (Wien), 2011, 153(10): 1931-1940.
[10] D'Amico RS, Banu MA, Petridis P, et al. Efficacy and out-comes of facial nerve-sparing treatment approach to cere-bellopontine angle meningiomas [J]. J Neurosurg, 2017, 127(6): 1231-1241.
[11] Nakamura M, Roser F, Dormiani M, et al. Facial and coch-lear nerve function after surgery of cerebellopontine angle meningiomas [J]. Neurosurgery, 2005, 57(1): 77-90.
[12] 葛志强,张世明,王中,等. 43例小脑桥脑角脑膜瘤诊疗体会[J]. 中国临床神经科学杂志,2013,21(2):151-154.
[13] Kane AJ, Sughrue ME, Rutkowski MJ, et al. Clinical and surgical considerations for cerebellopontine angle menin-giomas [J]. J Clin Neurosci, 2011, 18(6): 755-759.
[14] Park SH, Kano H, Niranjan A, et al. Stereotactic radiosur-gery for cerebellopontine angle meningiomas [J]. J Neuro-surg, 2014, 120(3): 708-715.
[15] Ding D, Starke RM, Kano H, et al. Gamma knife radiosur-gery for cerebellopontine angle meningiomas: a multicenter study [J]. Neurosurgery, 2014, 75(4): 398-408.

相似文献/References:

[1]杨佃旭 徐志明 李晓梅 王丽丽 王桂松.突入桥小脑角区胶质瘤的诊治分析(附5例报告)[J].中国临床神经外科杂志,2016,(03):171.[doi:10.13798/j.issn.1009-153X.2016.03.014]
[2]杨静波 李仕广.桥小脑角区脑膜瘤与内听道及颅神经关系的MRI特征分析[J].中国临床神经外科杂志,2015,(03):172.[doi:10.13798/j.issn.1009-153X.2015.03.016]
[3]佘苏华 邓兴力 李 杨 王 波 任仲坤 沈 勇 杨智勇 李 玉.微血管减压术治疗桥小脑角区颅神经压迫综合征的疗效分析[J].中国临床神经外科杂志,2015,(01):18.[doi:10.13798/j.issn.1009-153X.2015.01.006]
 SHE Su-hua,DENG Xing-li,LI Yang,et al.Microvascular decompression surgery for cranial nerve compression syndrome (report of 232 cases)[J].,2015,(03):18.[doi:10.13798/j.issn.1009-153X.2015.01.006]
[4]张道宝,朱晓丹,万晓强,等.神经内镜辅助技术在显微手术切除桥小脑角区肿瘤中的应用[J].中国临床神经外科杂志,2017,(02):103.[doi:10.13798/j.issn.1009-153X.2017.02.015]
[5]余海林 宋业纯 王晓松.单纯表现为面肌痉挛的桥小脑角区胶样囊肿1例[J].中国临床神经外科杂志,2017,(03):138.[doi:10.13798/j.issn.1009-153X.2017.03.003]
[6]董会晓 薛 健 段德义 程启龙.一期手术治疗双侧桥小脑角区胆脂瘤2例[J].中国临床神经外科杂志,2017,(05):366.[doi:10.13798/j.issn.1009-153X.2017.05.031]
[7]张 双 骆 静 袁国艳 张振宇 张作洪 赵信德 柯以铨 张旺明.手术治疗桥小脑角区大型脑膜瘤9例[J].中国临床神经外科杂志,2019,(12):762.[doi:10.13798/j.issn.1009-153X.2019.12.015]
[8]刘晓纬 陈科宇 罗绳祝 叶 峰 邓平福 葛元鸿 郑 毅 徐学君.以失聪为首发表现的桥小脑角区髓母细胞瘤1例[J].中国临床神经外科杂志,2020,(03):177.[doi:10.13798/j.issn.1009-153X.2020.03.018]
[9]张 喆 王立冲 虞 凯 杨 欢 谭子龙 肖 兵 涂 伟 沈晓黎.桥小脑角区原发性黑色素瘤1例[J].中国临床神经外科杂志,2021,26(06):489.[doi:10.13798/j.issn.1009-153X.2021.06.029]
[10]王泽易,陈鹏,高云,等.胰腺癌桥小脑角区转移1例[J].中国临床神经外科杂志,2023,28(06):414.[doi:10.13798/j.issn.1009-153X.2023.06.020]

更新日期/Last Update: 2019-03-25