【摘要】 目的 探讨神经内镜在颅内广泛多脑池表皮样囊肿切除手术中的应用及安全性。方法 回顾性分析2017年8月至2021年12月新疆医科大学第一附属医院神经外科收治的15例颅内广泛多脑池表皮样囊肿患者的临床资料。其中13例患者采用枕下乙状窦后入路，2例患者采用枕下乙状窦后入路联合颞下入路。观察患者的手术疗效及并发症发生情况。术后随访观察患者的症状恢复情况及头颅MRI弥散成像。结果 肿瘤全部切除12例（80.0%），近全切除2例（13.3%），部分切除1例（6.7%）。术后并发症包括复视2例，同侧瞳孔散大1例，无菌性脑膜炎1例，术区皮下积液1例。术后随访6～58个月，平均（30.5±16.0）个月。末次随访时，12例全切患者未见肿瘤复发，2例近全切和1例部分切除患者肿瘤未见明显增长。结论 神经内镜辅助显微镜技术能够提高颅内广泛多脑池表皮样囊肿的全切率，枕下乙状窦后入路“逆行”第三脑室底造瘘术安全可行。更多还原

【Abstract】 Objective To explore the application and safety of neuroendoscopy in the surgical removal of intracranial extensive multicompartmental epidermoid cysts.Methods A retrospective analysis was conducted on the clinical data of 15 patients with intracranial extensive multicompartmental epidermoid cysts treated in the Neurosurgery Department of the First Affiliated Hospital of Xinjiang Medical University from August 2017 to December 2021. Among these patients, 13 patients underwent surgery with suboccipital retrosigmoid approach, and 2 patients received surgery with a combination of the suboccipital retrosigmoid and infratemporal approaches. The surgical efficacy and incidence of complications of patients were observed. The patients were followed up to observe the recovery of symptoms and head MRI diffusion imaging.Results Complete tumor resection was achieved in 12 cases(80. 0%), near-total resection in 2 cases(13. 3%), and partial resection in 1 case(6. 7%). Postoperative complications included diplopia in 2 cases, ipsilateral mydriasis in 1 case, aseptic meningitis in 1 case, and subcutaneous fluid accumulation in the surgical area in 1 case. The follow-up period ranged from 6 to 58 months, with an average of(30. 5±16. 0) months. At the last follow-up, no tumor recurrence was observed in the 12 patients who underwent complete resection, no significant tumor growth was noted in the 2 patients with near-total resection and the 1 patient with partial resection.Conclusion Neuroendoscopic-assisted microscopy technology can improve the complete resection rate of intracranial extensive multicompartmental epidermoid cysts. Retrograde third ventriculostomy via suboccipital retrosigmoid approach is safe and feasible.更多还原