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山东大学学报（医学版） ›› 2016, Vol. 54 ›› Issue (10): 71-75.doi: 10.6040/j.issn.1671-7554.0.2016.130

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单纯神经内镜在桥小脑角区的手术应用

冯子超*,王济潍*,李超,李卫国,陈腾,马翔宇,徐淑军,李新钢   

  1. 山东大学齐鲁医院神经外科 山东大学脑科学研究所, 山东 济南 250012
  • 收稿日期:2016-02-08 出版日期:2016-10-10 发布日期:2016-10-10
  • 通讯作者: 李新钢. E-mail:lixg@sdu.edu.cn; 徐淑军. E-mail:xu-shujunql@163.com*共同第一作者. E-mail:lixg@sdu.edu.cn; xu-shujunql@163.com
  • 基金资助:
    国家自然科学基金(81501094);山东省优秀中青年科学家科研奖励基金(BS2011YY019)

Role of pure neuroendoscopy in cerebellopontine angle area surgery

FENG Zichao*, WANG Jiwei*, LI Chao, LI Weiguo, CHEN Teng, MA Xiangyu, XU Shujun, LI Xingang   

  1. Department of Neurosurgery, Qilu Hospital of Shandong University〓Brain Science Research Institute, Shandong University, Jinan 250012, Shandong, China
  • Received:2016-02-08 Online:2016-10-10 Published:2016-10-10

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摘要： 目的 探讨单纯神经内镜在桥小脑角区手术中的应用方法及临床价值。 方法 回顾性分析应用单纯神经内镜技术治疗96例桥小脑角区(CPA)病变的临床资料,并对其手术时间、手术疗效等进行评估。 结果 术中49例三叉神经痛患者均在内镜下发现责任血管,术后疼痛完全消失45例,疼痛较术前明显缓解4例;43例面肌痉挛患者均在内镜下发现责任血管,35例痉挛完全消失,7例明显缓解,1例未即刻缓解;4例桥小脑角区胆脂瘤能够清晰显示肿瘤与面、听神经的关系,3例全部切除,1例次全切除,肿瘤压迫症状均明显改善。随访期间,无死亡及复发病例。 结论 神经内镜能够单独完成桥小脑角区的诸多手术,具有微创、显露充分、视野清晰、减少并发症等优势,可以明显减小对正常脑组织牵拉和损伤,有临床推广价值。

关键词: 胆脂瘤, 神经内镜, 桥小脑角区, 三叉神经痛, 面肌痉挛

Abstract: Objective To explore the operative technique and clinical value of pure neuroendoscopy in surgeries on the cerebellopontine angle(CPA). Methods Clinical data of 96 patients with CPA diseases treated with pure neuroendoscopy were retrospectively analyzed. The operation time and therapeutic outcomes were evaluated. Results Of all 96 patients, 49 had trigeminal neuralgia, 43 had hemifacial spasm, and 4 had cholesteatoma. All of the responsible vessels, and the relation between tumor and auditory nerves and facial nerves were clearly shown under neuroendoscopy. Of the 49 patients with trigeminal neuralgia, 45 were pain free, and 4 achieved pain relief. Of the 43 patients with hemifacial spasm, 35 were symptom free, 7 were relieved, and 1 showed no immediate relief. Of the 4 patients with cholesteatoma, 3 underwent total ectomy and 1 received subtotal ectomy; the symptoms were greatly relieved. During the follow-up, no death or recurrence occurred. Conclusion It is feasible to complete a series of operations in the cerebellopontine angle area by pure neuroendoscopy, which can improve the surgical view with little damage to blood vessels and nerves. This technology is worth clinical application.

Key words: Neuroendoscopy, Trigeminal neuralgia, Cerebellopontine angle, Hemifacial spasm, Cholesteatoma

中图分类号: 

  • R616.2
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