摘要
目的探讨三叉神经痛型桥小脑角胆脂瘤的早期诊断及手术治疗,以减少并发症的发生。方法回顾性分析34例三叉神经痛型桥小脑角胆脂瘤病例资料,均表现为同侧三叉神经痛,经MRI扫描发现桥小脑角占位。采用乙状窦后入路切除肿瘤,其中22例同期行微血管减压术。结果肿瘤全切除26例,近全切除8例,病理确诊均为胆脂瘤。术后疼痛全部消失,面部麻木3例,短暂呛咳1例,无术后出血、急性脑积水、死亡等严重手术并发症。随访6~90个月,无疼痛复发及占位复发。结论桥小脑角胆脂瘤多以三叉神经痛为首发症状,MRI扫描可为早期诊断提供依据。手术切除病变可使多数病例疼痛消失,对于同时存在血管压迫的病例,可配合微血管减压术进行治疗。
Objective To explore the early diagnosis and surgical treatment for cholesteatoma at the cerebellopontine angle presented as trigeminal neuralgia and decrease the surgical complications. Methods The data of 34 patients who complained trigeminal neuralgia with cerebellopontine angle cholesteatoma were analyzed retrospectively. All the patients presented having trigeminal neuralgia at the same side of the cholesteatoma and showed a space-occupying lesion in the cerebellopontine angle by MRI. All tumors were resected through a retrosigmoid approach, for 22 patients, a microvascular decompression of the trigeminal nerve was performed at the same time. Results The tumor were totally removed in 26 patients and near-totally removed in 8. Pathological diagnosis was cholesteatoma. All the patient＇s trigeminal neuralgia disappeared, and the surgical complications included facial numbness in 3 patients and transient bucking in 1 patient. There were no serious complications as hematoma and acute hydrocephalus and death. During the follow-up of 6 to 90 months, no patient experienced pain recurrence or tumor recurrence. Conclusions Cerebellopontine angle cholesteatoma often present as trigeminal neuralgia firstly. MRI is helpful for early diagnosis according to its distinct signal. Surgical treatment is often the first choice, the neuralgia mostly disappears after operation. Microvascular decompression is recommended simultaneously if some offending vessels are founded during the surgical resection of the tumor.
出处
《中国微侵袭神经外科杂志》
CAS
2016年第8期351-353,共3页
Chinese Journal of Minimally Invasive Neurosurgery
关键词
胆脂瘤
三叉神经痛
桥小脑角
入路
乙状窦后
微血管减压术
cholesteatoma
lrigeminal neuralgia
cerebellopontine angle
approach, retrosigmoid
microvascular decompression
