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目的探讨两种入路切除向中后颅窝侵犯的哑铃型三叉神经鞘瘤的手术效果。方法对两种入路治疗的24例中后颅窝哑铃型三叉神经鞘瘤的手术效果进行分析,手术入路选择为幕上额颞开颅为基础辅以硬膜间(Dolenc)入路,幕下开颅枕下乙状窦后开颅为基础的硬膜下入路。结果经幕上组入路共16例,全切7例,次全切9例,经幕下组入路共8例,肿瘤全切6例,次全切2例。结论额颞硬膜间(Dolenc)入路残存率、死亡率较经枕下乙状窦后入路低,但肿瘤全切率及神经功能保留率较幕下入路低。
Objective To investigate the surgical results of two kinds of dumbbell-type trigeminal nerve schwannoma resected to the middle posterior fossa. Methods The surgical results of 24 cases of middle-posterior fossa dumbbell-type trigeminal schwannoma treated by the two approaches were analyzed. The choice of surgical approach was based on supratentorial temporal craniotomy supplemented with Dolenc approach, Curtain under the suboccipital sigmoid sinus craniotomy after the subdural approach. Results A total of 16 cases were treated by supratentorial approach, 7 cases were complete resection, 9 cases were subtotal resection, 8 cases were treated by submucosal approach, 6 cases were resected by tumor, 2 cases were subtotally resected. Conclusion The remnant rate and mortality of frontal frontal interduodenal membrane (Dolenc) approach are lower than that of posterior submandibular sinus, but the rates of full resection and neurological preservation are lower than those of infratentorial approach.