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1、CT骨窗位导航经颞下入路切除岩斜区肿瘤的临床研究CT骨窗位神经导航颞下经小脑幕入路切除岩斜区肿瘤的临床研究吕安康,钟东*,夏海坚,唐文渊,孙晓川,谭云,王兵,石爽(400016重庆,重庆医科大学附属第一医院神经外科)[摘要]目的:探讨CT骨窗位神经导航对颞下经小脑幕入路切除岩斜区肿瘤的临床意义。方法:对比重庆医科大学附属第一医院神经外科自2008年6月至2013年6月间治疗的16例未使用神经导航和27例使用骨窗位神经导航的岩斜区肿瘤患者的手术结果,均使用MedtronicStealthStationS7导航系统对27例患者进行神经导航,采用颞下经小脑幕入路对岩斜区肿
2、瘤进行切除。结果结果中没有体现与先前资料比较的内容。:未导航组16例患者中,6例达到显微镜下全切,8例次全切除,2例大部分切除;导航组27例患者中,16例达显微镜下全切,10例次全切除,1例大部分切除。结论:CT骨窗位神经导航定位精确,术中实时导航,有助于最大程度安全磨除岩骨,安全增加暴露,减少乙状窦、骨性半规管及神经组织等损伤,改善患者预后。[关键词]CT骨窗位;神经导航;颞下经小脑幕入路;岩斜区肿瘤TheClinicalResearchoftheResectionoftheTumorinPetroclivalRegionThroughSubtemporaltan
3、stentorialApproachunderCTBoneWindowNeuronavigationAnkangLv,DongZhong,HaijianXia,WenyuanTang,XiaochuanSun,YunTan,BingWang,ShuangShiDepartmentofNeurosurgery,theFirstAffiliatedHospitalofChongqingMedicalUniversity,1YouyiRoad,YuzhongDistrict,Chongqing,400016,ChinaAbstract:Objective:Toinvest
4、igatetheclinicalsignificanceofsubtemporaltranstentorialapproachunderCTbonewindowneuronavigationtoexcisingthetumorinpetroclivalregion.Methods:Compare16patientswithoutusingnavigationsystemto27patientsusingnavigationsysteminourdepartmentfromJune2008toJune2013useMedtronicStealthStationS7na
5、vigationsystemtoneuromavigate27patients,excisingthetumorinpetroclivalregionbysubtemporaltranstentorialapproach.Results:Amongthe16patientsusingnavigationsystem,6patientsunderwenttotaltumorectomyundermicroscope,8subtotaltumorectomyand2partialtumorectomy.Amongthe27patients,16patientsunder
6、wenttotaltumorectomyundermicroscope,10subtotaltumorectomyand1partialtumorectomy.Conclusions:ThepositioningofCTbonewindowneuronavigationisaccurate.Intraoperativereal-timenavigationhelpstomaximizethesafeabrasionofthepetrousbone,increasetheexposurerangesafely,andreduceinjuriesofthesigmoid
7、sinus,bonysemicircularcanalandneurologicalfunctions,leadingtoimprovetheprognosisofthepatients.Keywords:CTbonewindow;neuronavigation;subtemporaltranstentorialapproach;petroclivaltumor岩斜区肿瘤的概念是由Yasargil[1]最先提出的,广义上来讲指起源于或主体位于从鞍旁到枕骨大孔的广大区域的肿瘤,临床上通常将岩上窦和岩下窦之间的岩斜裂区称之为岩斜区[2],该部位肿瘤位置深,结构复杂,