临床神经外科杂志2016，Vol.13Issue(1)：1-4,4.DOI:10.3969/j.issn.1672-7770.2016.01.001
枕下极外侧髁上入路处理颈静脉孔区肿瘤
Resections for jugular foramen tumors through far lateral suboccipital supracondyle approach
卜博 1余新光 1张远征 1周定标 1戴朴 1申卫东1
作者信息
- 1. 100853 北京,中国人民解放军总医院神经外科
- 折叠
摘要
Abstract
Objective To explore the clinical value and applicability of resections for jugular foramen tumors through far lateral suboccipital supracondyle approach .Methods The clinical data of 75 patients with jugular foramen tumors operated by far lateral suboccipital supracondyle approach were analyzed .Of 75 patients , 28 were shwannomas , 25 paragangliomas , 11 meningiomas , 7 chordomas and 4 chondrosarcomas .The incision depended on the tumor extension direction and tumor size.Among the 75 cases, hook-shaped incisions were chosen in 42, curvilinear incisions were selected in 33 .The vertebral artery and occipito-atlas joint were exhibited and jugular foramen was opened from supracondyle direction .Results Of 75 patients,51 received total resection of the tumors,17 subtotal resection and 7 partial resection.Postoperative CSF leakage occurred in 5 cases. The patients were followed up from 3 to 24 months.Intraoperative neurophysiologic monitoring was beneficial to preservation of residual caudal cranial nerves .33 cases had no newly-developed cranial nerve dysfunctions .16 patients presented with slight hoarse and no dysphasia at the time of follow-up at least 3 months later .None permanent placement of gastro or tracheal tube .Conclusions The approach was performed without much more resection of petrous bone and skeletonization of facial nerve .We can get an extensive exposure without worsen the stability of crania-vertebral junction .The key of operation is to demonstrate different anatomy corridor according to the size and orientation of individual tumors .This approach is apt for the tumors with their main part within jugular foreman and extending to posterior fossa or craniocervical junction .关键词
颈静脉孔区肿瘤/枕下极外侧入路/显微手术Key words
jugular foramen tumors/far lateral suboccipital supracondyle approach/micro-surgery分类
医药卫生引用本文复制引用
卜博,余新光,张远征,周定标,戴朴,申卫东..枕下极外侧髁上入路处理颈静脉孔区肿瘤[J].临床神经外科杂志,2016,13(1):1-4,4.
