颈静脉孔区肿瘤各手术入路的选择及对比分析

颈静脉孔区肿瘤位置深,结构复杂,周围有重要的神经血管走形,此区域肿瘤类型较多,常见的有颈静脉球瘤,其次为神经鞘瘤和脑膜瘤。由于此区域位置深,结构复杂,手术显露困难,切除此区域肿瘤难度较大,选择合适的手术入路以及术中正确的处理是该区域肿瘤手术成功的关键。此区域的手术入路可分为三种:后方入路、侧方入路、前方入路;各自又有新型的改良术式。手术入路的选择取决于病变性质、生长范围、受累结构、患者的功能状态及术者的个人经验。术中保护重要的神经血管是此手术的关键。尽管如此,术后出现的并发症在所难免,其主要的并发症有:脑神经损伤后功能障碍、脑脊液漏和脑膜炎等。

Analyze and Select Surgical Approach of Tumor in the Jugular Foramen

Position of tumors in jugular foramen area is deep,and its structure is complex,surrounded by important nerves and blood vessels.There are many tumor types in the region.The common ones are jugular bulb tumors,nerve sheath tumors and menin-giomas.Because of the deep position,complex structure and few surgical exposure,it is difficult to remove tumors in this region.So it becomes the key point for surgery success to select the appropriate surgical approach and intraoperative correct treatment.There are three types of surgical approach to the area: back approach,lateral approach,anterior approach.Each type has developed its new modified type of operation.The choice of surgical approach depends on the nature of disease,growth range,the involved structure,the patient’s func-tional status and the surgeon’s personal experience.Intraoperative protection of important nerves and blood vessels is the sticking point to the operation.However,postoperative complications are inevitable,and the main complications are brain dysfunction after injury,cere-brospinal fluid leak and meningitis.