【摘要】 目的:探讨神经内镜辅助显微外科在颅内胆脂瘤手术治疗中的应用价值。方法应用神经内镜辅助显微外科手术治疗桥小脑角区胆脂瘤25例,其中单纯桥脑小脑角区胆脂瘤17例,另8例生长累及幕上鞍区、斜坡、第三脑室或对侧桥脑小脑角区;手术采用乙状窦后入路17例,翼点入路4例,颞下入路3例,对应的半球入路1例;显微镜下尽可能切除肿瘤可见部分,再用神经内镜探查并切除残留肿瘤,对于术后仍遗留有面瘫、麻木、神经痛等患者,则尽早配合康复治疗。结果:25例患者中肿瘤全切23例(92%)。术后患者原有症状明显好转21例(84%),部分改善4例(16%)。术后遗留有面瘫、麻木、神经痛等患者经配合理疗和针刺后恢复较好。结论:内镜辅助神经外科手术治疗颅内胆脂瘤,能够提高肿瘤切除率,减少创伤和术后并发症,提高安全性,缩短住院时间。更多还原

【Abstract】 Objective: To study the value of endoscope-assisted neurosurgical technique in the treatment of intracranial epidermoid cyst. Methods: Endoscope-assisted neurosurgical technique was applied in 25 cases of intracranial epidermoid cysts, in which there were 17 cases of cerebellopontine angle epidermoid cyst, and 8 cases of epidermoid cysts extending to sellar, clival, third ventricle or opposite CPA region. Craniotomy and surgical approaches included suboccipital retrosigmoid (17 cases), pterion (4 cases), subtemporal (3 cases) and transcorticle approach (1 case). Most part of tumors were resected under a microscope, then the residual tumors explored and resected under a neuroendoscope. The patients who suffered from facial paralysis and neuralgia after operation underwent rehabilitative treatment as early as possible. Results: In these 25 cases, residual tumors were found under a neuroendoscope after routine microsurgery and resected. Total resection rate was 92% (23/25 cases). Twenty/25 cases (84%) obviously recovered from former symptoms postoperation and 4/25 partially removed. Conclusion: Endoscope-assisted neurosugical treatment of intracranial epidermoid cyst can increase total resection rate, reduce surgery-related trauma, improve safety of the operation, decrease occurrence of complications, shorten the hospital stay. The patients complicated with postoperative facial paralysis and neuralgia could obtain satisfactory effects by acupuncture and physical therapy.更多还原