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Abstract：
Objective To highlight the advantages and disadvantages of the combined translabyrinthine (TL) and classic retrosigmoid (RS) approaches. Design Retrospective chart review. Setting National tertiary referral center for skull base pathology. Participants Twenty-two patients with very large cerebellopontine angle tumors were resected using the combined TL-RS approach. Main Outcome Measures Preoperative patient characteristics including age, sex, and hearing loss. Tumor characteristics, pathology, and size. Intraoperative outcome: tumor removal. Postoperative outcomes included facial nerve function, residual tumor growth, and neurological deficits. Results Thirteen patients had schwannoma, eight had meningioma, and one had both. The mean age was 47 years, mean tumor size was 39 × 32 × 35 mm (anterior-posterior, medial-lateral, craniocaudal), and mean follow-up period was 80 months. Tumor control was achieved in 13 patients (59%), and 9 (41%) had residual tumor growth that required additional treatment. Seventeen patients (77%) had postoperative House-Brackmann (H-B) facial nerve function grades I to II, one had H-B grade III, one H-B grade V, and three H-B grade VI. Conclusion Combining TL and RS approaches may be helpful in safely removing large meningiomas and schwannomas in selected cases. This valuable technique should be considered when sufficient exposure cannot be achieved with the TL or RS approach alone.
摘要：
目的探讨经迷路(TL)与经典乙状窦后(RS)联合入路的优缺点。设计回顾性图表审查。设置国家三级颅底病理学转诊中心。参与者使用联合的TL-RS方法切除了22例非常大的桥小脑角肿瘤患者。术前患者特征，包括年龄，性别,和听力损失。肿瘤特征，病理学,和大小。术中结果：肿瘤切除。术后结果包括面神经功能，残余肿瘤生长，和神经缺陷。结果13例患者均有神经鞘瘤,八个人患有脑膜瘤，一个人两者都有。平均年龄是47岁,平均肿瘤大小为39×32×35mm(前后，内侧-外侧,颅尾)，平均随访期为80个月。13例患者（59%）实现肿瘤控制，和9（41％）有残留的肿瘤生长，需要额外的治疗。17例患者（77％）术后House-Brackmann（H-B）面神经功能I至II级，其中一人H-B等级为III级,一个H-B等级V，和三个H-B级VI。结论TL和RS联合入路可能有助于部分病例安全切除大型脑膜瘤和神经鞘瘤。当单独使用TL或RS方法无法实现足够的暴露时，应考虑这种有价值的技术。
