INC国际神经外科学院主席Couldwell教授109例岩斜区脑膜瘤手术经验

　　INC国际神经外科学院主席Couldwell教授109例岩斜区脑膜瘤手术经验
 

　　INC国际神经外科医生集团、国际神经外科学院院长、国际脑膜瘤协会前主席William T. Couldwell教授关于109例岩斜区脑膜瘤手术经验的论文交流：Petroclival meningiomas: surgical experience in 109 cases
 

　　论文英文原文：The surgical removal of petroclival meningiomas has historically been associated with a high incidence of morbidity and mortality. The 109 consecutive patients included in the present retrospective study represent a combined series of tumors operated on by the four authors during a period from 1980 to 1992. The series is composed of 40 men and 69 women ranging in age from 25 to 75 years (mean 51 years). Surgical approaches to tumors in this series included simple retromastoid (60 cases), combined supra- and infratentorial petrosal (22), transtemporal (primary transsigmoid retrolabyrinthine, translabyrinthine, or transcochlear (12)), subtemporal (11), and frontotemporal transcavernous (eight). Grosstotal removal was achieved in 75 patients (69%). Recurrence or progression of disease occurred in 14 patients (13%) over a 6.1-year mean follow-up period, and it was found within the cavernous sinus in 12 of these cases. Four recurrent cases demonstrated histological compatibility with malignant meningioma. Perioperative death occurred in four patients, and there were 56 significant complications in 35 other patients. Review of this series, with the attendant complications, has facilitated the authors’ decision-making when considering the risk of gross-total removal in selected patients with asymptomatic cavernous sinus invasion or tumor adherent to the brainstem.

　　中文摘要：从历史上看，手术切除石斜坡脑膜瘤与发病率和死亡率的高发生有关。本回顾性研究中包括的109位连续患者代表了四位作者在1980年至1992年期间手术治疗的一系列肿瘤。该系列由40位男性和69位女性组成，年龄从25岁到75岁不等（平均51年）。该系列肿瘤的外科手术方法包括简单的后乳突（60例），合并上，下肌腱膜的岩性（22），经颞部的（主要经乙状窦后迷路，经迷路或经耳蜗（12）），颞下（11）和额颞经海绵窦（8）。 75名患者（69％）实现了总切除。在6.1年的平均随访期内，有14例患者（13％）发生了疾病的复发或进展，其中12例在海绵窦内发现。四个复发病例显示与恶性脑膜瘤的组织学相容性。 4例患者发生围手术期死亡，另外35例患者发生56例并发症。考虑到无症状海绵窦浸润或肿瘤附着于脑干的部分患者的总切除风险，本系列文章的回顾以及伴随的并发症为作者的决策提供了便利。