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作者报告105例桥小脑角肿瘤手术治疗,强调联合径路和CO_2激光的应用价值。手术方法: 1.经迷路进路:不论肿瘤大小,均可经迷路切除。患者仰卧,头转向健侧或术侧肩部稍抬高。切口在耳郭皱折后方3cm,自耳郭上方至乳突尖。完成单纯乳突凿开术。若术野暴露不充分、则从中部掀开乙状窦前、后骨板,用骨蜡充填压迫乙状窦。迷路切除是自三个半规管和前庭上方切除耳被囊显露面神经的鼓室段。以水平半规管及上半规管的壶腹和筛区为界标,显露前庭上神经管。除去与内耳道上、后、下邻接的骨板显露管的硬脑膜。除去颅后窝硬脑膜上的骨板。小心去除盖在内耳道及桥小脑角肿瘤上的全部骨质,去除内耳道最外端上方的骨质时尤须小心。于颅后窝切开硬脑膜,暴露肿瘤。切开靠近肿瘤下极的蛛网膜下脑池放出脑脊液,肿瘤乃得以减
The authors report 105 cases of cerebellopontine angle tumor surgery, emphasizing the combined path and CO_2 laser application value. Surgical methods: 1. The lost way: No matter the size of the tumor, can be lost by excision. Patient supine, head turned to the contralateral or slightly elevated shoulder surgery. Incision in the back of the ear wrinkles 3cm, from the top of the ear to mastoid tip. Complete mastoid surgery. If the surgical field exposure is not sufficient, then opened the middle of the sigmoid anterior and posterior plate, filling the sigmoid sinus with bone wax. Lost resection is from the three semicircular canal and vestibular resection of the ear capsule was exposed facial nerve tympanic segment. The level of semicircular canal and upper semicircular canal ampulla and sieve area as a landmark, revealing the vestibular neural tube. Remove the dura with the canal adjacent to the inner ear canal, posterior, inferior to the exposed tube. Remove the cranial fossa dura on the bone plate. Care should be taken to remove all the bone covered in the internal auditory meatus and cerebellopontine angle tumors. Care must be taken when removing the bone above the outermost end of the internal auditory meatus. Dural incision in the posterior fossa, exposing the tumor. Cut the subarachnoid cistern close to the lower pole of the tumor and release cerebrospinal fluid. The tumor is reduced