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The history of the combined supra-and infratentorial approach to the petroclival region

机译：岩石斜坡区超导和红外结合方法的历史

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摘要

Lesions of the ventrolateral brainstem, clivus, and cerebellopontine angle pose significant challenges for surgeons,and the rate of morbidity and mortality from classic neurosurgical approaches has proven to be unacceptably high. Early attempts to expose this region consisted primarily of an extended suboccipital craniectomy, with opening of the tentorium andligation of the sigmoid sinus for additional exposure. During the 1960s, technological innovations including the surgical microscope and the pneumatic drill allowed surgeons to gain additional exposure by removing more bone from the base of theskull. This let surgeons define combined infra-and supratentorial approaches, which rely less on brain retraction to resect these difficult tumors successfully. These approaches rely on a combined posterior mastoid approach with an anterior petrosectomy. The evolution of this approach is discussed in this paper.
机译：腹外侧脑干，锁骨和小脑桥角的病变对外科医生提出了重大挑战，并且经典神经外科手术的发病率和死亡率已被证明是高得令人难以接受的。早期对该区域进行暴露的尝试主要包括扩大枕下颅骨切除术，张开tor和乙状窦结扎以进行进一步暴露。在1960年代，包括手术显微镜和气动钻在内的技术创新使外科医生可以从颅骨的底部去除更多的骨头，从而获得更多的暴露。这使外科医生定义了组合式的上下方法，这些方法较少依靠脑部回缩来成功切除这些困难的肿瘤。这些方法依赖于后乳突联合前路岩性切除术。本文讨论了这种方法的演变。

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