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目的探讨岩斜区肿瘤合理的术前风险评估、临床分型及手术入路。方法回顾性分析62例岩斜区肿瘤显微外科手术资料。根据影像学特征和临床表现,将岩斜区肿瘤进行分型和术前风险评估,并比较不同手术入路的疗效。结果肿瘤全切除38例(61%):扩大翼点入路3例,颞下经小脑幕入路8例,乙状窦前入路6例,乙状窦后入路21例。术后新增神经功能障碍26例(42%),围手术期无死亡病例。结论手术入路的选择应结合术前风险评估及肿瘤分型综合考虑。对于术前评估风险大的肿瘤,结合肿瘤分型,应选择相对简单、微创的乙状窦后入路或颞下经小脑幕入路。
Objective To investigate the reasonable preoperative risk assessment, clinical classification and surgical approach of petroclival tumors. Methods A retrospective analysis of 62 cases of petroclival tumor microsurgery data. According to the imaging features and clinical manifestations, the petroclival tumors were classified and preoperative risk assessment, and compared the efficacy of different surgical approaches. Results Total tumor removal was performed in 38 cases (61%): 3 cases were enlarged pterional approach, 8 cases were infratemporal transurethral approach, 6 anterior sigmoid sinus approach and 21 posterior sigmoid sinus approach. There were 26 cases (42%) of new neurological dysfunction after operation, and no perioperative death was found. Conclusion The choice of surgical approach should be combined with preoperative risk assessment and tumor type comprehensive consideration. For preoperative risk assessment of large tumors, combined with the tumor type, should choose a relatively simple, minimally invasive sigmoid sinus posterior approach or infratemporal transimithiva.