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目的 探讨颈静脉孔区神经鞘瘤的临床分型和手术疗效。方法 对 17例颈静脉孔区神经鞘瘤患者的临床表现、手术方式和预后进行回顾性分析。 17例患者中 ,男性 8例 ,女性 9例 ,就诊前平均病程 5 3 2个月 ;主要临床表现有Ⅶ、Ⅷ颅神经损伤 ,舌肌萎缩和后组颅神经损害 ;按Samii分类法 ,A型 5例、B型 3例、C型 2例、D型 7例。结果 手术采用远外侧入路 10例 ,枕下入路 5例 ,经下颌骨、经颌下入路 2例 ;全切除肿瘤 12例 ,次全切除 5例 ;术后症状改善 9例 ,症状同术前 3例 ,术后出现神经功能损害加重 5例 ,其中 2例出现暂时性声音嘶哑 ,随访中好转。 2例术后出现吞咽困难 ,1例有轻度面瘫。结论 根据肿瘤的生长方式 ,选择适当手术入路 ,可通过手术切除颈静脉孔区神经鞘瘤 ,并可获得良好手术效果
Objective To investigate the clinical classification and surgical treatment of schwannoma in jugular foramen region. Methods The clinical manifestations, surgical methods and prognosis of 17 patients with schwannoma of the jugular foramen were retrospectively analyzed. Among 17 patients, there were 8 males and 9 females, with an average duration of 532 months before treatment. The main clinical manifestations were Ⅶ, Ⅷ cranial nerve injury, lingual muscle atrophy and cranial nerve lesion in the posterior group. According to the Samii classification, A 5 cases, 3 cases of type B, 2 cases of type C and 7 cases of type D. Results The operation was performed in 10 cases of distal lateral approach and 5 cases of suboccipital approach. The mandibular and mandibular approach were performed in 2 cases. Totally resected tumors were performed in 12 cases and subtotally removed in 5 cases. Symptoms were improved in 9 cases Three cases were preoperatively, and 5 cases had postoperative neurological impairment. Among them, 2 cases had transient hoarseness and improved during follow-up. Two patients had dysphagia after operation, and one had mild facial paralysis. Conclusion According to the growth of the tumor, choose the appropriate surgical approach, surgical removal of nerve sheath tumors of the jugular foramen region, and obtain good surgical results