摘要目的 探讨颈静脉孔区脑膜瘤的显微外科手术治疗方法和临床疗效.方法 回顾性分析了1996年4月至2011年4月北京天坛医院28例行显微外科手术切除的颈静脉孔区脑膜瘤患者,依据分型采用枕下乙状窦后入路13例,远外侧入路9例,耳后“C”形经髁上入路4例、经髁旁入路2例.结果 肿瘤全切除18例,次全切除10例,本组22例得到随访,随访时间平均3年.19例随访KPS评分在80分以上,12例仍有不同程度的声嘶或呛咳症状,11例生活可自理,2例死于肿瘤复发.结论 颈静脉孔区脑膜瘤有较高复发率,术后出现后组颅神经功能损伤发生率较高.根据不同分型的肿瘤选择合适的手术入路可取得较好的治疗效果.

abstractsObjective To explore the microsurgical treatment and clinical efficacies of jugular foramen meningiomas.Methods A total of 28 patients with jugular foramen meningiomas undergoing microsurgical operations at Beijing Tiantan Hospital during the period from April 1996 to April 2011 were analyzed retrospectively.The retrosigmoid suboccipital (n =13),far lateral (n =9),postauricular transsupracondylar (n =4) and trans-paracondylar approaches (n =2) were used.Results Complete tumor resection was achieved in 18 patients and subtotal tumor resection in 10 patients.Twenty-two patients were followed up for a mean follow-up period of 3 years.The postoperative Karnofsky performance scale was above 80 in 19 patients.Twelve patients experienced hoarseness or bucking,11 lived independently and 2 died of tumor recurrence.Conclusion Jugular foramen meningiomas have a higher recurrence rate and severe cranial nerve damages may occur postoperatively.It is important to classify them into different clinical entities and choose appropriate surgical approaches and techniques so as to achieve satisfactory outcomes.