三叉神经鞘瘤的诊断和显微外科治疗策 略简

目的探讨三叉神经鞘瘤的诊断及治疗策略。方法回顾性分析41例三叉神经鞘瘤的病例资料。最常见症状为面部麻木或感觉减退。按肿瘤位置分为5型：颅中窝型3例，颅后窝型8例，颅中后窝哑铃型26例，颅中窝颅外型2例，颅中后窝颅外型2例。采用额颞硬膜外入路13例，颞底经天幕入路14例，乙状窦后入路11例，乙状窦前入路3例。结果肿瘤全切35例，次全切除5例，大部分切除1例。随访13例，时间3～84个月，复发2例。结论影像学检查对三叉神经鞘瘤诊断具有重要意义。个体化手术入路可获得满意的切除程度和较少并发症。

The diagnosis and microsurgical treatment strategy for trigeminal neurinoma

Objective To explore the diagnosis and treatment strategy for trigeminal neurinoma. Methods Clinical data of 41 patients with trigeminal neurinoma were analyzed retrospectively. The most common symptoms were facial numbness or hypoesthesia. According to their location, the tumors were divided into five types： middle fossa （3 cases）, posterior fossa （8 cases）, middle and posterior fossae （26 cases）, middle fossa and extracranial space （2 cases）, and middle and posterior fossae and extracranial space （2 cases）. Frontotemporal epidural approach was adopted for microsurgery in 13 patients, subtemporal transtentorial approach in 14, retrosigmoid approach in 11 and presigmoid approach in 3. Results Total tumor resection was achieved in 35 patients, subtotal resection in 5 and partial resection in 1. Thirteen patients were followed up for 3-84 months, 2 were found having recurrence. Conclusions The CT or MR/ scan is useful for diagnosis. Individualized approach can achieve a higher tumor resection and lower complications.