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目的探讨中颅窝底硬膜外入路显微手术治疗三叉神经鞘瘤的方法和疗效。方法回顾性分析采用中颅窝底硬膜外入路显微手术治疗的27例三叉神经鞘瘤病人的疗效。结果27例病人中肿瘤全切除25例,次全切除2例。术后颅神经功能障碍较术前改善18例,无明显变化4例,加重5例,出现新的颅神经麻痹4例(不完全性麻痹);2例出现脑脊液漏和颅内感染,经腰穿置管脑脊液引流和抗生素治疗痊愈。本组无术后死亡病例,术后随访6~48个月,除1例于手术后40个月复发并行二次手术治疗外,其余病人均恢复良好。结论该入路对脑组织牵拉轻,术野显露好,可进行多角度操作,有助于提高肿瘤的全切率、降低病残率。
Objective To explore the method and effect of microsurgical treatment of trigeminal schwannoma at the middle cranial fossa epidural. Methods Retrospective analysis of 27 cases of trigeminal schwannoma treated with microsurgical treatment of middle skull base epidural. Results Twenty-five cases were resected from the tumor in 27 cases and subtotally resected in two cases. There were 18 cases with cranial nerve dysfunction after operation, 4 cases without obvious change, 5 cases with aggravating, 4 cases with new cranial nerve paralysis (incomplete paralysis), 2 cases with cerebrospinal fluid leakage and intracranial infection, Were placed in cerebrospinal fluid drainage and antibiotic therapy healed. No postoperative deaths were observed in this group. The patients were followed up for 6 to 48 months. All patients recovered well except for one case relapsed 40 months after operation and the second operation. Conclusions This approach has the advantages of light traction on the brain tissue, good surgical field exposure, multi-angle operation, helps to improve the full-rate of the tumor and reduce the morbidity.