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目的提出颞下经岩骨嵴入路切除岩斜区脑膜瘤的方法,使手术更加简便、安全、微创,以替代各型联合入路,降低手术致残、致死率。方法10%甲醛固定的国人成人头颅湿标本10例、漂白的颅骨干标本10例,模拟手术操作并对手术涉及的重要结构测量、拍照;手术前后共10例20侧标本进行CT岩骨薄扫,并对重要结构进行测量、拍照。结果颞下经岩骨嵴入路涉及的重要解剖结构包括Labbe静脉、岩骨内部结构、脑干腹侧间隙等。重要参数包括岩骨嵴磨除范围。结论颞下经岩骨嵴入路通过对岩骨嵴的磨除,增加对岩骨背侧肿瘤基底的暴露,适合切除骑跨中后颅窝的岩斜脑膜瘤。该入路具有操作简单、创伤小、安全性高的特点。
Objective To propose a method of resection of petroclival meningiomas by petrosal skull approach, which makes the operation simple, safe and minimally invasive, so as to replace all kinds of combined approaches and reduce the degree of surgical disability and lethality. Methods 10 cases of 10% formalin-fixed adult head skull wet specimens and 10 cases of bleached skull stem specimens were simulated and the important structures involved in the operation were measured and photographed. Ten specimens , And measure the important structure, take pictures. Results The major anatomic structures involved in the subtemporal approach to the petrous ridge include the Labbe’s vein, the internal structure of the petrous bone, and the ventral space of the brainstem. Important parameters include the rock ridge crest clearance range. Conclusions Temporomandibular crest approach through the debridement of the petrous ridge can increase the exposure to the base of the dorsal side of the petrous bone and is suitable for the removal of lithospheric meningioma riding across the middle and posterior cranial fossa. The approach has the advantages of simple operation, less trauma and high safety.