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目的 采用显微外科技术切除枕大孔区脑膜瘤 ,重点分析手术入路及技巧。方法 总结天坛医院 1993年 5月至 1997年 3月采用显微外科技术切除 19例枕大孔区脑膜瘤的经验。结果 19例中 4例采用枕下中线入路 ,其余 15例均采用远外侧入路 ,全切除 16例 ,次全切除 3例 ,术后有 6例行暂时性气管切开 ,无手术死亡。结论 枕大孔区脑膜瘤手术切除虽然困难 ,危险性较大 ,但采用显微外科技术合理选择最佳手术入路 ,肿瘤全切率及颅神经保护率会明显提高 ,并能获得长期满意疗效
Objective To use microsurgical technique to remove the meningioma in the foramen magnum, focusing on the surgical approach and skills. Methods From May 1993 to March 1997, Tiantan Hospital was performed microsurgical resection of 19 cases of meningioma in the foramen magnum. Results Of the 19 cases, 4 cases underwent the suboccipital midline approach. The other 15 cases were treated by far lateral approach. Total resection was performed in 16 cases and subtotal resection in 3 cases. Postoperatively, 6 cases underwent temporary tracheotomy without any operative death. Conclusions Although it is difficult and dangerous to remove the meningioma in the foramen magnum, the best choice of microsurgery is to choose the optimal surgical approach. The total tumor resection rate and cranial nerve protection rate will be significantly improved and the long-term satisfactory curative effect can be obtained