摘要
目的总结功能神经导航系统下高枕部经皮质入路切除侧脑室三角区及周围病变的经验。方法回顾性分析35例侧脑室三角区及周围病变病人的临床资料。均在BrainLAB神经导航系统下经高枕部入路切除病变,切口位于枕外粗隆上5～8 cm,中线旁2～4 cm。统计分析手术前、后失语指数(aphasia quotient,AQ)评分。结果病变全切除31例,次全切除4例。术后病理:脑膜瘤14例,胶质瘤11例,海绵状血管瘤4例,转移瘤2例,室管膜瘤1例,中枢神经细胞瘤1例,脉络丛乳头状癌1例,生殖细胞瘤1例。术后偏瘫加重3例,偏盲2例。随访35例,时间3～12个月,3例偏瘫及1例偏盲病人均好转,另1例偏盲无改变。5例术前语言功能障碍病人较术后早期改善明显(AQ=95.2±2.58,P<0.05);30例术前语言功能正常病人,除2例语言功能恶化外,其余均正常(AQ=94.9±6.37)。结论神经导航下高枕部入路便于操作、容易显露病变,能成功避开重要神经功能传导束,降低术后功能障碍发生率,是治疗侧脑室三角区及周围病变的有效方法。
Objective To summarize the surgical experiences of removal of the lesions in and around the lateral ventricle trigone via high occipital approach under neuronavigation.Methods The clinical data of 35 patients with lesions in and around the lateral ventricle trigone were analyzed retrospectively.The lesions were removed via a high occipital approach by guidance of BrainLAB neuronavigation.The incision site was 5 to 8 cm superior to the external occipital protuberance and 2 to 4 cm lateral to the midline.The aphasia quotient（AQ） scores before and after the operation were analyzed statistically.Results Total resection of lesions was achieved in 31 patients and subtotal resection in 4.The postoperative pathological analysis showed that there were 14 cases of meningioma,11 of glioma,4 of cavernous hemangioma,2 of metastasis,1 of ependymoma,1 of central neurocytoma,1 of choroid plexus papillary carcinoma and 1 of germinoma.The hemiparalysis was aggravated in 3 patients and hemianopia occurred in 2 after operation.Thirty-five patients were followed up for 3 to 12 months,and there was obvious improvement in 3 hemiparalysis patients and 1 hemianopia patient,but another hemianopia patient unchanged.Compared with the early stage after operation,the language function of 5 patients with preoperative speech impairment was improved significantly（AQ=95.2±2.58,P〈0.05）.The function of 30 patients with preoperative normal speech remained unchanged（AQ=94.9±6.37） but 2 patients whose language function was worsened.Conclusions Brain surgery via high occipital approach by guidance of neuronavigation has several advantages such as convenient operation,good surgical field exposure condition and getting out of the important nerve conduction bunches,which could result in decrease of postoperative dysfunction rate,thus is an effective method for treatment of lesions in and around the lateral ventricle trigone.
出处
《中国微侵袭神经外科杂志》
CAS
北大核心
2011年第10期437-439,共3页
Chinese Journal of Minimally Invasive Neurosurgery
基金
北京市自然科学基金(编号:7102145)
关键词
侧脑室
入路
高枕部
神经导航
神经外科手术
lateral ventricle
high occipital approach
neuronavigation
neurosurgical procedures
