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目的总结改良翼点-经颞叶-经小脑幕(modified pterional transtemporal transtentorial,MPTT)入路手术切除三叉神经鞘瘤的疗效及经验。方法回顾性分析31例经MPTT入路切除三叉神经鞘瘤病人的临床资料,包括颅中窝型10例,颅中后窝骑跨型21例。结果肿瘤全切除29例,次全切除1例,大部分切除1例。所有病人随访3~90个月,1例病人肿瘤复发伴巨大囊肿再次手术。其余病人头晕、头痛等症状消失,面部麻木、感觉减退状况好转。结论 MPTT入路是切除颅中窝型、颅中后窝骑跨型三叉神经鞘瘤合适的入路选择,该入路暴露充分,视角佳,全切除率高。
Objective To summarize the curative effect and experience of modified pterional approach - surgical removal of trigeminal schwannoma via the modified pterional transtemporal transtentorial (MPTT) approach. Methods The clinical data of 31 patients with trigeminal schwannoma resected by MPTT were retrospectively analyzed. Among them, 10 were middle cranial fossa type and 21 were posterior cranial nest type. Results Tumor resection in 29 cases, subtotal resection in 1 case, the majority of resection in 1 case. All patients were followed up for 3 to 90 months. One patient had recurrent tumor with giant cyst and reoperated. The remaining patients dizziness, headache and other symptoms disappear, facial numbness, feeling diminished condition improved. Conclusion MPTT approach is a suitable approach for resection of cranial fossa type and posterior cranial fossa type trigeminal schwannoma. The route of exposure is adequate, the angle of view is good and the rate of total resection is high.