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目的 探讨中、后颅窝(MP)型三叉神经鞘瘤的诊断与治疗,以提高该类肿瘤的切除程度与术后疗效。方法 回顾性分析24例MP型三叉神经鞘瘤的临床资料。切除肿瘤取颞底经天幕入路者14例,枕下乙状窦后入路等其他手术入路者1O例。结果肿瘤全切除21例,次全切除2例和大部切除1例。出院时好转23例,加重1例。结论 实体性MP型三叉神经鞘瘤需与中、后颅窝脑膜瘤相鉴别;囊性MP型三叉神经鞘瘤需与表皮样囊肿相鉴别。对于MP型三叉神经鞘瘤,取颞底经天幕入路可获良好效果,并具有显露容易、创伤小、可直视海绵窦及其内侧的神经血管,以及到达后颅窝肿瘤距离近、较直视等优点。
Objective To investigate the diagnosis and treatment of middle and posterior fossa (MP) type trigeminal schwannoma in order to improve the resection degree and postoperative efficacy of this kind of tumor. Methods The clinical data of 24 cases of MP trigeminal schwannoma were retrospectively analyzed. Excision of tumors taken from the temporal approach via the cantilever in 14 cases, suboccipital sigmoid sinus approach and other surgical approach 1O cases. Results Tumor resection in 21 cases, subtotal resection in 2 cases and partial resection in 1 case. 23 cases improved at discharge, aggravated in 1 case. Conclusion The MP-type trigeminal schwannoma need to be differentiated from the posterior fossa meningiomas. Cystic MP-type trigeminal schwannoma should be differentiated from epidermoid cyst. For the MP type trigeminal schwannoma, take the temporal fundus approach can get good results, and with easy to reveal, trauma, can directly look at the cavernous sinus and its medial nerve blood vessels, and to reach the posterior fossa tumor near, more Direct and so on.