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目的:探讨颅底岩骨斜坡区表皮样囊肿显微外科治疗的手术入路、切除技巧及神经保护方法等。 方法:2 1例岩斜区表皮样囊肿患者中 ,11例采用枕下乙状窦后入路 ,7例采用颞枕经小脑幕入路 ,4例采用颞枕枕下乙状窦后幕上下联合入路手术。结果:肿瘤全切 8例 ,肿瘤次全切 13例。术后临床症状及体征完全消失者 8例 ,较术前明显好转者 4例 ,基本同术前者 8例 ,死亡 1例。 结论 :手术入路的选择应取决于肿瘤的起源和累及部位 ;保护神经功能的关键是应用显微技术囊内切除肿瘤后锐性分离包膜 ,在与神经血管粘连紧密处留部分包膜 ,不强行剥离
Objective: To investigate the surgical approaches, surgical techniques and neuroprotective methods for microsurgery of epidermoid cysts in skull base rock slope areas. Methods: Twenty-one cases of epileptiform epidermoid cyst with petroclival were treated with suboccipital sigmoid sinus approach, 7 cases with temporal occipital commissural approach, and 4 cases with temporal occipital sigmoid sinus posterior curtain Joint approach surgery. Results: Tumor resection in 8 cases, subtotal tumor in 13 cases. Postoperative clinical symptoms and signs of complete disappearance in 8 cases, compared with preoperative significant improvement in 4 cases, basically the same as in 8 cases, 1 died. Conclusion: The choice of surgical approach should depend on the origin and location of the tumor; the key to protect the nerve function is the use of microscopic techniques of intracapsular tumor after sharp separation of the capsule, the nerve and blood vessels in the adhesions remain part of the envelope, Not forcibly stripped