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目的 :介绍哑铃型三叉神经鞘瘤的手术治疗经验。方法 :对作者近 5年来收治的 10例这类病例进行回顾性分析。结果 :10例手术均行颞下 -经小脑幕入路肿瘤一期切除 ,全切率 10 0 % ,手术无一例死亡 ,术前突眼、后组颅神经麻痹、锥体束征、小脑体征及颅内高压症状均逐渐消失 ,术后仅出现暂时动眼神经麻痹 1例 ,周围性面瘫 2例 ;术后全部随访 ,随访时间 6月至 5年 ,仅一例术后 2年复发 ,生活均能自理。结论 :哑铃型三叉神经鞘瘤显微手术全切是其最佳方法 ,颞下 -经小脑幕入路行是一良好手术途径 ,其术野显露充分 ,易于达到肿瘤全切 ,微创 ,符合脑保护要求 ,术后并发症少。
Objective: To introduce the experience of surgical treatment of dumbbell-type trigeminal schwannoma. Methods: A retrospective analysis of 10 cases of these cases admitted to the author in the recent 5 years. Results: All the 10 cases underwent the operation of subtotal - transcntal incision tumor resection, with a total resection rate of 100%. There was no death in the operation. The preoperative anterior and posterior group cranial nerve palsy, pyramidal tract sign, cerebellar sign And symptoms of intracranial hypertension gradually disappeared. Only 1 case of temporary oculomotor nerve paralysis and 2 cases of peripheral facial paralysis were found after operation. All patients were followed up for 6 months to 5 years after operation. Only one case had recurrence 2 years after operation, Can take care of themselves. Conclusion: Dumbbell-type trigeminal schwannoma is the best method of microsurgical resection. The approach of TMJ is a good surgical approach. The operative field is well exposed and easy to achieve complete tumor resection, minimally invasive and conforming Brain protection requirements, fewer postoperative complications.