摘要：

目的 总结内镜下经颅脑桥小脑角区肿瘤切除术的手术要点。方法 纳入2019年1月至2020年12月中南大学湘雅医院诊断与治疗的28例脑桥小脑角区肿瘤患者，均行内镜下经颅入路手术切除脑桥小脑角区肿瘤。结果 28例患者均顺利完成内镜下经颅脑桥小脑角区肿瘤切除术，并全切除肿瘤。术后经病理证实听神经瘤9例，脑膜瘤8例，胆脂瘤9例，血管母细胞瘤1例，三叉神经鞘瘤1例。术后面神经功能Ⅲ级3例，Ⅱ级6例，Ⅰ级19例。术后1例听力障碍缓解不明显；2例出现头晕、眩晕、恶心症状；无一例出现脑脊液漏、脑膜炎、切口感染等并发症，无死亡病例。随访3个月时复查MRI均未见肿瘤复发，亦未出现新的神经系统症状。结论 内镜下经颅脑桥小脑角区肿瘤切除术具有诸多优点，亦存在一定不足，具有较好的发展前景。

关键词: 脑肿瘤, 小脑脑桥角, 神经内窥镜

Abstract:

Objective To summarize the key points of neuroendoscopic transcranial resection for cerebellopontine angle (CPA) tumors. Methods Twenty-eight patients with CPA tumors diagnosed and treated in Xiangya Hospital Central South University from January 2019 to December 2020 were included, and all of them underwent neuroendoscopic transcranial surgery to remove CPA tumors. Results All the 28 patients were successfully treated with neuroendoscopic transcranial resection of tumors in CPA region, and the tumors were totally removed. After operation, 9 cases of acoustic neuroma, 8 cases of meningioma, 9 cases of cholesteatoma, one case of hemangioblastoma, and one case of trigeminal neurinoma were confirmed by postoperative pathology. Postoperative facial nerve function was grade Ⅲ in 3 cases, grade Ⅱ in 6 cases, and grade Ⅰ in 19 cases. One patient had no obvious recovery of auditory nerve function injury, and 2 patients had dizziness, vertigo and nausea after operation. No complications such as cerebrospinal fluid leakage, meningitis and incision infection occurred, and no death occurred. At 3 months of follow-up, no tumor recurrence was seen on MRI, and no new neurological symptoms occurred. Conclusions Neuroendoscopic transcranial resection of CPA tumors has many advantages, but also has some shortcomings, and has a good development in the future.

Key words: Brain neoplasms, Cerebellopontine angle, Neuroendoscopes