INC國際神經(jīng)外科學(xué)院主席Couldwell教授109例巖斜區(qū)腦膜瘤手術(shù)經(jīng)驗
 

　　INC國際神經(jīng)外科醫(yī)生集團、國際神經(jīng)外科學(xué)院院長、國際腦膜瘤協(xié)會前主席William T. Couldwell教授關(guān)于109例巖斜區(qū)腦膜瘤手術(shù)經(jīng)驗的論文交流：Petroclival meningiomas: surgical experience in 109 cases
 

　　論文英文原文：The surgical removal of petroclival meningiomas has historically been associated with a high incidence of morbidity and mortality. The 109 consecutive patients included in the present retrospective study represent a combined series of tumors operated on by the four authors during a period from 1980 to 1992. The series is composed of 40 men and 69 women ranging in age from 25 to 75 years (mean 51 years). Surgical approaches to tumors in this series included simple retromastoid (60 cases), combined supra- and infratentorial petrosal (22), transtemporal (primary transsigmoid retrolabyrinthine, translabyrinthine, or transcochlear (12)), subtemporal (11), and frontotemporal transcavernous (eight). Grosstotal removal was achieved in 75 patients (69%). Recurrence or progression of disease occurred in 14 patients (13%) over a 6.1-year mean follow-up period, and it was found within the cavernous sinus in 12 of these cases. Four recurrent cases demonstrated histological compatibility with malignant meningioma. Perioperative death occurred in four patients, and there were 56 significant complications in 35 other patients. Review of this series, with the attendant complications, has facilitated the authors’ decision-making when considering the risk of gross-total removal in selected patients with asymptomatic cavernous sinus invasion or tumor adherent to the brainstem.

　　中文摘要：從歷史上看，手術(shù)切除石斜坡腦膜瘤與發(fā)病率和死亡率的高發(fā)生有關(guān)。本回顧性研究中包括的109位連續(xù)患者代表了四位作者在1980年至1992年期間手術(shù)治療的一系列腫瘤。該系列由40位男性和69位女性組成，年齡從25歲到75歲不等（平均51年）。該系列腫瘤的外科手術(shù)方法包括簡單的后乳突（60例），合并上，下肌腱膜的巖性（22），經(jīng)顳部的（主要經(jīng)乙狀竇后迷路，經(jīng)迷路或經(jīng)耳蝸（12）），顳下（11）和額顳經(jīng)海綿竇（8）。 75名患者（69％）實現(xiàn)了總切除。在6.1年的平均隨訪期內(nèi)，有14例患者（13％）發(fā)生了疾病的復(fù)發(fā)或進展，其中12例在海綿竇內(nèi)發(fā)現(xiàn)。四個復(fù)發(fā)病例顯示與惡性腦膜瘤的組織學(xué)相容性。 4例患者發(fā)生圍手術(shù)期死亡，另外35例患者發(fā)生56例并發(fā)癥?？紤]到無癥狀海綿竇浸潤或腫瘤附著于腦干的部分患者的總切除風(fēng)險，本系列文章的回顧以及伴隨的并發(fā)癥為作者的決策提供了便利。