周范民 徐 健 上海医科大学附属华山医院神经外科(200040) 中国神经精神疾病杂志 1999 0 25 4


    关键词：桥小脑角；巨大肿瘤；手术 期刊 zgsjjsjbzz 0 论著与学术交流 fur -->


    

【摘要 】 目的 为桥小脑角巨大肿瘤提供临床鉴别和手术治疗依据。方法 回顾分析80例桥小脑角巨大肿瘤资料。结果 80例肿瘤中，听神经瘤46例(57.5%)，脑膜瘤15例(18.8%)，上皮样囊肿6例(7.5%)，三叉神经瘤5例(6.3%)及其它少见肿瘤8例(10%)。平均年龄44.6岁，平均病程4.36年。临床表现以一侧听力下降(70%)、共济失调(58.8%)及头痛(53.5%)为主。后组颅神经损害的发生率(26.3%)明显增高。MRI确诊率达90.9%。枕下入路手术68例，幕上下联合入路手术12例。肿瘤全切除率53.8%，面神经保留率81.3%，手术死亡率8.8%，术后症状改善36例，维持原状35例。随访42例，平均随访期2.8年。生活自理者38例，复发3例。结论 桥小脑角巨大肿瘤种类多样。临床鉴别主要依靠影像学检查。手术疗效令人满意。

The clinical analysis of 80 cases of hugecerebellopontine angle tumors.

Zhou Fanmin and Xu Jian,

    Department of Neurosurgery, Huashan Hospital,Shanghai Medical University, 12 WulumugiZhong Road, Shanghai. 20040. Tel:021-62489999-487

【Abstracts 】ObjectiveToprovide clinical identification and surgical methods for various huge tumors ofcerebellopontine angle (CPA).Methods Retrospective analysis of 80 cases of huge CPAtumors.Results Of 80 cases 46 were acoustic neuromas (57.5%), 15 meningiomas (18.5%), 6epidermoid cysts(7.5%), 5 trigeminal neuromas (6.3%) and 8 other rare tumors(10%).Averageage was 44.6 years and illness duration was 4.36 years. The major symptoms and physicalsigns were unilateral hearing loss (70%), ataxia (58.8%) and headache (53.5%). Theincidence of posterior cranial nerves injury(26.3%) was evidently high. The correctpreoperative diagnosis rate of MRI was 90.9%. 68 cases had been operated throughsuboccipital approach and 12 cases through combined approach. The complete removal ratewas 53.8%, facial nerve retention rate was 81.3% and mortality rate was 8.8%. 71 caseshowed condition improved or persisted. 42 cases were followed-up for an average of 2.8years and 38 patients could live by themselves. 3 cases were recurrent. ConclusionsThehuge CPA tumors were divided several types. CT and MRI were the most sensitive methods fordiagnosis. Surgical results were satisfactory.

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