国际神经外科学院院长Couldwell教授解读中颅窝入路切除听神经瘤-INC国际神经外科医生集团

　　国际神经外科学院院长Couldwell教授解读中颅窝入路切除听神经瘤

　　Middle fossa approach for resection of vestibular schwannoma--中颅窝入路切除前庭神经鞘瘤（听神经瘤）

　　英文原文摘要

　　Background：Surgical approaches for removal of vestibular schwannoma are done through retrosigmoid, translabyrinthine, or middle fossa approaches, depending on the tumor size, preoperative hearing status, surgical team experience, and patient preference. The middle fossa approach (MFA) for the vestibular schwannoma (VS) route preserves hearing and can be done with minimal morbidity and mortality.

　　Method：The authors discuss the surgical anatomy of the middle fossa, internal auditory canal localization techniques, MFA indications and the procedure for VS removal, and outcome.

　　Conclusion：Unlike otolaryngologists, who use the MFA to treat various pathological processes that involve the inner or middle ear, many neurosurgeons are unfamiliar with the MFA. Nevertheless, learning the technical nuances of the MFA adds to the neurosurgeon’s armamentarium, especially for treatment of small intracanalicular VSs in young patients who wish to preserve hearing.

　　中文摘要

　　背景：切除听神经瘤（前庭神经鞘瘤）的手术方法可通过乙状窦后入路，经迷路或中窝进行，具体取决于肿瘤的大小，术前听力状况，手术团队的经验以及患者的喜好。前庭神经鞘瘤（VS）途径的中窝入路（MFA）可以保持听力，并且可以将发病率和死亡率降至较低。

　　方法：作者讨论了中颅窝的手术解剖、内耳道定位技术、MFA适应症以及VS切除的程序以及结局。

　　结论：与使用MFA治疗涉及内耳或中耳的各种病理过程的耳鼻喉科医生不同，许多神经外科医生对MFA不熟悉。然而，了解MFA的技术细微之处会增加神经外科医师的武器库，是对于希望保留听力的年轻患者，治疗小管内小血管瘤。