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目的 探讨三叉神经鞘瘤的诊断与手术入路选择。方法 回顾性分析28例三叉神经鞘瘤的临床资料。结果 肿瘤获全切除25例,次全切除2例和大部切除1例。出院时好转27例,加重1例。结论 三叉神经鞘瘤可分成为:①颅中窝型;②颅后窝型;③颅中后窝型;④颅外型;⑤颅中窝颅内外沟通型;⑥颅中后窝颅内外沟通型。颅中窝型肿瘤宜取翼点或改良翼点入路;颅后窝型肿瘤宜取枕下乙状窦后入路;颅中后窝型肿瘤宜取颞底经天幕入路;颅中窝颅内外沟通瘤宜取颞下硬脑膜外入路。
Objective To investigate the diagnosis and surgical approach of trigeminal schwannoma. Methods The clinical data of 28 patients with trigeminal schwannoma were retrospectively analyzed. Results The tumor was totally resected in 25 cases, subtotal resection in 2 cases and subtotal resection in 1 case. 27 cases improved at discharge, an increase of 1 case. Conclusion The trigeminal nerve schwannoma can be divided into: the middle cranial fossa type; the posterior fossa type; the posterior fossa type of the cranium; the extracranial type of the cranial fossa; type. Cranial fossa tumors should be taken from the wing point or modified pterional approach; posterior fossa tumor should take suboccipital sigmoid sinus approach; posterior fossa tumor should take the temporal fundus by the cantilevered approach; cranial fossa Intracranial communicating tumor should take the inferior epidural approach.