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目的探讨三叉神经鞘瘤的显微手术入路。方法回顾分析经手术和病理证实的三叉神经鞘30例的临床治疗结果,结合文献复习该肿瘤的最佳手术入路选择。结果三叉神经鞘瘤术前诊断并不困难,正确选择手术入路是确保全切肿瘤的关键,本文报告30例患者采取不同的手术入路行显微手术,全切率达50%,肿瘤大部以上切除率达83.3%,取得良好效果。结论三叉神经鞘瘤显微手术治疗最佳方法,中颅窝肿瘤主张采用颞下入路,后颅窝肿瘤枕下乳突后入路是最佳选择,哑铃型肿瘤根据不同情况采取颞下经小脑幕或颞下-乙状窦前入路等联合入路效果良好。
Objective To explore the microsurgical approach of trigeminal schwannoma. Methods The clinical results of 30 cases of trigeminal nerve sheath proved surgically and pathologically were retrospectively analyzed, and the optimal surgical approach to the tumor was reviewed according to the literature. Results preoperative diagnosis of trigeminal nerve sheath tumors is not difficult, the correct choice of surgical approach is to ensure that the key to complete resection of the tumor, the paper reported 30 patients underwent different surgical approaches to microsurgery, the full rate of 50%, large tumor Above the Ministry of removal rate of 83.3%, and achieved good results. Conclusions The best method of microsurgical treatment of trigeminal schwannoma is that the middle cranial fossa tumor advocates the use of inferior temporal approach and the posterior fossa tumor posterior occipital papillary approach is the best choice. According to different situations, Cerebellum or infratemporal-sigmoid sinus anterior approach combined with good results.