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目的探讨引起脑干受压的胆脂瘤的临床表现，影像学特点，手术治疗及预后情况。方法经磁共振成像（MRI）和计算机体层摄影（CT）及手术证实的胆脂瘤9例，位于脑干腹侧面8例，脑干左侧1例。临床表现早期无症状或不典型，晚期可具有脑干轻微受压表现。全部行手术治疗，其中肿瘤及包膜全切2例，包膜及肿瘤次全切3例，包膜保留内容全切4例。结果4例术后出现化学性脑膜炎，经治疗后痊愈，5例表现为一组或多组脑神经障碍。结论①引起脑干受压的胆脂瘤，其影像学改变与临床表现不同步，影像学反映的病灶大，临床上却不能表现相应的症状。②手术治疗以保留神经功能为主，不必强行剥离肿瘤包膜。
Objective To investigate the clinical manifestations, imaging features, surgical treatment and prognosis of cholesteatoma which cause brainstem compression. Methods Nine patients with cholesteatoma confirmed by magnetic resonance imaging (MRI) and computed tomography (CT) and surgeries were located in the ventral surface of the brain stem in 8 cases and in the left side of the brain stem in 1 case. Clinical manifestations of early asymptomatic or atypical, late may have a slight compression of the brainstem performance. All patients underwent surgical resection, including 2 cases of full resection of the tumor and capsule, 3 cases of subtotal resection of the capsule and tumor, and 4 cases of complete preservation of the capsule. Results Four patients had chemical meningitis after operation, recovered after treatment and one or more neurological disorders in 5 patients. Conclusion ① The cholesteatoma which causes brainstem compression is not synchronized with the clinical manifestations. The lesions reflected by the imaging are large, and the corresponding symptoms can not be manifested clinically. Surgical treatment to retain the main neurological function, do not have to forcibly peel the tumor capsule.