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目的 探讨三叉神经鞘瘤的诊断和治疗方法。方法 回顾性分析 1 7例三叉神经鞘瘤的临床资料 ,其中Ⅰ型(中颅窝型) 3例采用颞下入路或额颞眶颧入路切除 ;Ⅱ型 (后颅窝型 ) 6例采用额颞眶颧入路或枕下乳突后入路切除 ;Ⅲ型 (哑铃型 ) 8例分别采用颞下入路、枕下乳突后入路或幕上、下联合入路切除。本组全切除 1 6例 ,次全切除 1例。结果 本组主要表现为三叉神经损害的症状和体征 ,1 4例获MR确诊。1 0例门诊随访 2～5年无复发者 ,Karnofsky评分 :8例 >80分 ,2例 60～ 70分。结论 三叉神经鞘瘤早期进行CT、MR检查均可明确诊断 ,显微手术治疗是最佳方法 ,正确选择手术入路是肿瘤全切除的前提条件。
Objective To investigate the diagnosis and treatment of trigeminal schwannoma. Methods The clinical data of 17 patients with trigeminal schwannoma were retrospectively analyzed. Among them, type Ⅰ (middle cranial fossa) were resected under the infratemporal or frontotemporal or zygomatic approach in 3 cases. Type Ⅱ (posterior fossa) The frontotemporal zygomatic approach or suboccipital mastoid approach was used for resection. The type Ⅲ (dumb-bell-shaped) approach was performed under the infratemporal approach, posterior suboccipital approach or supratentorial approach respectively. The group of 16 cases of total resection, subtotal resection in 1 case. Results This group mainly showed the symptoms and signs of trigeminal nerve injury, 14 cases were confirmed by MR. 10 outpatients were followed up for 2 to 5 years without recurrence, Karnofsky score: 8 cases> 80 points, 2 cases 60 to 70 points. Conclusion Trigeminal schwannoma early CT, MR examination can confirm the diagnosis, microsurgical treatment is the best method, the correct choice of surgical approach is the prerequisite for total tumor resection.