颅后窝胆脂瘤162例的诊断与显微手术处理

目的：为了提高颅后窝胆脂瘤的诊断水平与手术治疗效果。方法：总结分析１６２例颅后窝胆脂瘤的临床征象、诊断方式、显微手术入路与疗效。结果：１４９例（９２．０％）肿瘤获全切除，余１３例（８．０％）因肿瘤包膜与脑干粘连紧密而行次全切除。４例（２．５％）于手术后２周内因脑干缺血、水肿或肺部感染死亡。１３例获长期随访（平均４．５ａ），有１２９例（９６．３％）恢复良好；２例（１．５％）肿瘤有复发，需行再次手术切

Diagnosis and microsurgical management of 162 patients with cholesteatoma in the posterior fossa

AIM: To improve the diagnostic level and surgical curative effects of cholesteatoma in the posterior fossa. METHODS: Analyse and summarize the clinical data including the clinical main manifestations, diagnostic modes, microsurgical approaches and outcome of 162 patients with cholesteatoma in the posterior fossa. RESULTS: Total removal of the tumor was made in 149 patients (92.0%) and subtotal removal of the capsule of tumor was made in the remaining 13 patients (8.0%), due to tight adhesion to the brain stem. 4 patients died (2.5%) because of brain stem ischemia or edema or lung infection within two weeks postoperatively. Long term follow up (mean 4.5 years) in 134 patients revealed good recovery of 129 patients (96.3%) and only 2 patients (1.5%) had recurrence and needed reoperative management. CONCLUSION: Early diagnosis and microsu rgical management is of great importance in improving the curative effects of cholesteatoma in the posterior fossa.