目的:探讨在经岩周乙状窦前入路切除岩斜区肿瘤手术中采用钬激光辅助消融肿瘤的特点、操作技巧和疗效.方法:采用Fukushima提出的经岩周乙状窦前入路、钬激光辅助切除岩斜区肿瘤15例并对其临床资料进行回顾性分析.结果:全组病例包括脑膜瘤9例,表皮样囊肿3例,神经鞘瘤2例,桥脑胶质瘤1例.获肿瘤全切除11例,次全切除3例,大部切除1例.术后新出现暂时性颅神经障碍3例,无死亡.结论:对于质地坚韧、血供丰富且手术暴露视野较小的岩斜区肿瘤,钬激光能精确可靠地配合显微镜下进行显微操作,气化、切割消融肿瘤,减少术中出血及术中牵拉,有助于提高肿瘤切除程度和术后疗效.

Objective: To discuss the characteristic、operative technique and surgical outcome of Ho:YAG laser applied in parapetrosal presigmoid approach for removal of petroclival tumors. Methods: 15 petroclival tumors have been treated microsurgically by parapetmsal presigmoid approach developed by Fukushima, in which Ho:YAG laser has been applied. The clinical data have been analysed retrospectively. Results: In our series, there were 9 meningiomas, 2 epidermoid cysts, 2 schwannomas, and 1 pontine gliomas. Total resection was performed in 11 patients, subtotal resection in 3, and partial resection in 1. Transient cranial nerve paresis occurred newly in 3 patients postoperatively. No death occurred. Conclusions: Ho:YAG laser can be used to ablate and vaporize petroclival tumors effectively whose vascular supply is abundant and the texture is very tough. It can be used to reduce the bleeding and shift of the tumor in the operation, to raise the removal degree and curative effect. So it is suitable for microsurgical treatment of petroclival tumors