扩大额颞入路切除中颅窝沟通性肿瘤42例临床研究..doc

扩大额颞入路切除中颅窝沟通性肿瘤42例临床研究 刘信龙 徐正平 许峰峰 李明 杨冰 肖丽鸿 廖环 万里靖 王丽芳 解放军455医院神经外科（上海市 200052） 【摘要】? 目的 总结扩大额颞入路切除中颅窝沟通性肿瘤外科治疗经验。 方法 回顾性分析扩大额颞入路切除中颅窝沟通性肿瘤42例的外科治疗经验。 结果 肿瘤全切除32例，次全切除6例，大部切除4例，无手术死亡。术后症状消失18例，好转的24例。手术并发症：三叉神经感觉根部分损伤15例，眼动神经损伤6例，视神经损伤3例,面神经损伤1例。术后脑脊液漏3例，咬合错位1例，颅内感染1例。 结论 扩大额颞手术入路切除中颅窝沟通性肿瘤，术中离断颧弓，腰大池引流脑脊液降低颅内压，术野宽阔，从颅外开始切除肿瘤，可以较好的保护脑和神经功能，减少手术并发症。 【关键词】?中颅窝 沟通性肿瘤 外科手术 ???Extended frontotemporal approach for resection of middle cranial fossa communicating tumors : clinical study of 42 cases ???LIU XinLong,XU ZhengPing,XU FengFeng,LI Ming, YANG Bing, XIAO LiHong,LIAO Huan,WAN LiJing,WANG LiFang ?? Department of Neurosurgery, 455 Hospital of PLA, Shanghai , 200052 ???[ Abstract ] Objective To summarize surgical treatment experience on the extended frontotemporal approach for resection of middle cranial fossa communicatiing tumors. Methods Retrospective analysis of surgical treatment experience on extended frontotemporal approach for resection of middle cranial fossa communicating tumors in 42 cases . Results Total tumor resection in 32 cases, subtotal resection in 6 cases, partial resection in 4 cases, no operation death. Symptoms disappeared in 18 cases, improved in 24 cases. Operation complications: part of sensory root of trigeminal nerve injury in 15 cases, oculomotor nerve injury in 6 cases, optic nerve injury in 3 cases ,1 cases with facial nerve injury. Cerebrospinal fluid leakage in 3 cases, bite dislocation in 1 case, 1 case of intracranial infection. Conclusion Extended frontotemporal approach for resection of middle cranial fossa communicating tumors, with disconnection of the zygomatic arch and lumbar cisterm cerebrospinal fluid drainage to reduce intracranial pressure in operation , from the extracranial began to resection of the tumor, provide wide operative field, better protecting the brain and nerve function, reducing operation complications.?? ? Key words:? middle cranial