资源描述：
《通过外耳道顶切除颞下内肿瘤》由会员上传分享，免费在线阅读，更多相关内容在行业资料-天天文库。
1、JNeurosurg74:520-522,1991RemovaloftheroofoftheexternalauditorymeatusinapproachingthetentorialnotchthroughalowtemporalcraniotomyTechnicalnoteMARCP.SINt)OU,M.D.,D.Sc.BIoL.,ANDJEAN-LucFOBi:,M.D.DepartmentofNeurologicalSurgery,HOp#a~Neurologique,UniversityofLyon,Lyon,France
2、u-Improvedaccesstothetentorialnotchcanbeobtainedbyremovaloftheroofoftheexternalauditorymeatusinassociationwithalowtemporalcraniotomy.Thisapproachdecreasestemporalloberetractionandtheriskofvenousinfarction.Thismethodwasperfectedinthesurgicallaboratoryonfivecadaversandwas
3、successfullyperformedinapatientwithagiantaneurysmoftheposteriorcerebralartery.KEYWORDS'subtemporalapproach 9tentorialnotch 9externalauditorymeatus 9aneurysm,giant 9posteriorcerebralarteryHEclassicalapproachtothetentorialnotchanditsboneroof.Thetemporalmuscleisincisedinat
4、othepeduncularregion,includingtheposteriorcruciformfashionandreflectedinferiorly.Alowtem-Tcerebralartery(PCA)anditsP2andP3seg-poral4.0•3.0-cmcraniotomyisperformedjustabovements,isbythesubtemporalroute.Theabsenceofatheexternalauditorymeatus.Theduramaterofthecisterninthes
5、ubtemporalregionoftenleadstosignifi-temporalfossaisdetachedfromtheskullbaseaswellcanttemporalloberetractionwhichmayresultintheasthesoftexternalauditorymeatus.TheroofofthesacrificeoftheveinofLabb6andotherbridgingveinsexternalauditorymeatusisremovedatasecondstagetothetran
6、sverseandtentorialsinuses.Todecreasewithasagittalvibratingsaw(Fig.1A)anditstemporaltemporalloberetractionandtherisksofedemaandandzygomaticedgesaredrilledofftoprovidemorevenousinfarction,anapproachtothetentorialnotchroom.Themastoidcells,ifopened,mustbecarefullyhasbeendev
7、elopedwhichinvolvesremovaloftheroofoccludedwithbonewax.Theduraisopenedandre-oftheexternalauditorymeatusinassociationwithaflectedinferiorly.Underthesurgicalmicroscope,thelowtemporalcraniotomy.Wehaveperfectedthiscom-temporallobeisgentlyretractedwithtwonarrowSugitabinedapp
8、roachinthesurgicallaboratorybilaterallyonretractors?~Specialcareistakennottoteartheveinoffivecadavers(Tablel)a
