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目的探讨枕下乙状窦后入路骨瓣开颅和复位的手术方法及临床应用。方法对31例桥小脑角区病变经枕下乙状窦后入路骨瓣开颅手术病人的病历资料进行回顾分析。结果骨瓣开颅均顺利完成,获得了满意的术野显露,骨瓣切除平均用时48 min。术后无一例发生脑脊液感染和发热,1例拆线后第2天发现脑脊液通过裂开的切口外漏,经及时处理,7 d后痊愈出院。结论枕下乙状窦后入路骨瓣开颅是安全、快捷、可行的。骨瓣复位可以降低术后脑脊液漏和感染的发生。
Objective To investigate the surgical methods and clinical application of craniotomy and reduction of posterior subethic sinus approach. Methods 31 cases of cerebellopontine angle lesion were retrospectively analyzed by transclinical transcervical sigmoid sinus surgery. Results The skull craniotomy was successfully completed and satisfactory surgical field was revealed. The average time for resection of the bone flap was 48 min. None of the patients had any cerebrospinal fluid infection and fever after operation. One patient was found to have leakage of cerebrospinal fluid through the incision incision on the second day after suture removal. After being treated promptly, he was discharged after 7 days. Conclusion Posterior subrethrochoidal sinus approach craniotomy craniotomy is safe, fast and feasible. Bone flap reduction can reduce postoperative cerebrospinal fluid leakage and infection.