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首页> 外文期刊>Neurosurgery >Partial labyrinthectomy petrous apicectomy approach to neoplastic and vascular lesions of the petroclival area.
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Partial labyrinthectomy petrous apicectomy approach to neoplastic and vascular lesions of the petroclival area.

机译：部分迷路切除术岩性顶叶切除术可治疗岩丘区的肿瘤和血管病变。

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OBJECTIVE: To study the value of an improvement of the presigmoid petrosal approach to the petroclival area by the addition of partial labyrinthectomy and petrous apicectomy and to document hearing and other results. METHODS: Thirty-six consecutive patients treated by this technique during a 2-year period were studied prospectively. The lesions treated included 33 petroclival neoplasms (25 meningiomas, 5 chordomas, 1 chondrosarcoma, 1 trigeminal schwannoma, and 1 epidermoid cyst) and 3 vertebrobasilar aneurysms. The patients underwent clinical, radiological, and neuro-otological examinations. RESULTS: There was no perioperative mortality. Cranial nerve deficits involving Cranial Nerves III, IV, V, and VI occurred in 17 patients (47%) postoperatively. Cerebrospinal fluid leak occurred in 12 patients (33%). Four of these patients were treated by lumbar drainage, two patients were treated by lumboperitoneal shunt, and six patients required reoperation and repacking of the middle ear. Hydrocephalus occurred in five patients (13.9%). There was one case of meningitis and another of systemic sepsis. All 36 patients underwent postoperative audiometric evaluation. When serviceable hearing was present preoperatively (Gardner-Robertson Grades I or II), it was determined to be preserved at postoperative follow-up in 81% of the patients (26 of 32 patients). CONCLUSION: The partial labyrinthectomy petrous apicectomy approach provided improved access to neoplasms of the clivus and petrous apex and the posterior cavernous sinus area and to vertebrobasilar aneurysms in the midclival area. This improvement in access permits more controlled and thorough treatment of these lesions, with reduced brain retraction and acceptable morbidity with respect to auditory function.
机译：目的：研究通过增加部分迷路切除术和岩性顶突切除术来改善乙状结肠前路的方法，并记录听力和其他结果。方法：前瞻性研究了连续2年使用该技术治疗的36例患者。所治疗的病变包括33例石棺肿瘤（25个脑膜瘤，5个脊索瘤，1个软骨肉瘤，1个三叉神经鞘瘤，1个表皮样囊肿）和3个椎基底动脉瘤。患者接受了临床，放射学和神经耳科检查。结果：没有围手术期死亡。术后17例（47％）发生涉及颅神经III，IV，V和VI的颅神经缺陷。脑脊液漏发生12例（33％）。这些患者中有四名接受了腰椎引流治疗，两名患者接受了腰腹分流治疗，六名患者需要再次手术并重新包装中耳。 5例（13.9％）发生脑积水。一例发生脑膜炎，另一例发生系统性败血症。全部36例患者均接受了术后听觉评估。术前出现可服务的听力时（Gardner-Robertson I级或II级），在术后随访中确定81％的患者（32名患者中的26名）可以保留听力。结论：部分迷路切除术岩性顶突切除术可以更好地接近锁骨和岩质顶点和后海绵窦区域的肿瘤，以及进入中腹区的椎基底动脉瘤。通路的这种改善允许对这些病变进行更可控制和彻底的治疗，同时减少脑部回缩和就听觉功能而言可接受的发病率。

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