外侧颅底的迷路入路:术前颞骨 CT 分析的价值

IF 0.9 Q3 OTORHINOLARYNGOLOGY
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引用次数: 0

摘要

目的 达到小脑-桥脑角的最常用神经外科方法是后穹隆途径。本文介绍了蝶骨前入路,该方法需要对迷宫阻滞有充分的了解,同时需要对颞骨 CT 进行定量分析。方法对采用蝶骨前入路进行前庭神经切除术的患者进行基于 CT 的定量测量。共招募了 18 名患者,进行了五项测量:Trautmann面积、瓣-瓣角、蝶骨前硬脑膜长度及其角度。结果后半环管(PSC)-乙状窦(SS)距离、乙状硬膜前硬膜-内耳道(IAC)-PSC角度和手术时间是并发症的预测因素。具体来说,PSC-乙状窦距离<11 mm、硬脑膜前-内耳道(IAC)-PSC角度<14与并发症的最高风险相关。Trautmann三角区和瓣隙角缩小具有挑战性,可通过显微镜-内窥镜联合技术和光学角度旋转来解决。迷宫后入路可以保留听力,并将小脑回缩减至最小。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Retrolabyrinthine approach to the lateral skull base: The value of preoperative temporal bone CT analysis

Purpose

The most used neurosurgical approach to reach cerebellar-pontine angle is the retrosigmoid route. This article describes the presigmoid approach which requires excellent knowledge of the labyrinthine block together with quantitative analysis of temporal bone CT.

Methods

CT-based quantitative measurements were obtained in patients undergoing vestibular neurectomy with a presigmoid approach. Eighteen patients were enrolled, and five measures were taken: Trautmann’s area, the petro-clival angle, presigmoid dura length and its angle. The relationship between these measurements and hospitalization days, operating times, and complications was explored.

Results

The posterior semicircilar canal (PSC)-sigmoid sinus (SS) distance, presigmoid dura- internal auditory canal (IAC)-PSC angle, and duration of surgery are predictors of complications. Specifically, a PSC-sigmoid sinus distance <11 mm, a dura presig-IAC-PSC angle <14 are associated with the highest risk of complications.

Conclusion

Preoperative temporal bone CT scan can guide the surgeon through the narrowest areas of the surgical approach. Trautmann’s triangle area and petro-clival angle reduction are challenging and can be faced with combined microscopic-endoscopic technique, and with optics angulation-rotation. The retrolabyrinthine approach can enable hearing preservation and minimal cerebellar retraction.
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来源期刊
CiteScore
1.40
自引率
20.00%
发文量
44
审稿时长
44 days
期刊介绍: Es la revista más importante en español dedicada a la especialidad. Ofrece progresos científicos y técnicos tanto a nivel de originales como de casos clínicos. Además, es la Publicación Oficial de la Sociedad Española de Otorrinolaringología y Patología Cérvico-Facial y está presente en los más prestigiosos índices de referencia.
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