Abstract：
OBJECTIVE: The objective of this study was to evaluate the clinical effect and safety of the postauricular infratemporal fossa approach (ITFA) in resecting jugular foramen lesions.
METHODS: All 25 patients undergoing microsurgery via postauricular ITFA from March 2015 to May 2023 in the Department of Neurosurgery, Tangdu Hospital, Air Force Military Medical University were included. The clinical and radiological data were retrospectively analyzed. Regular follow-up was carried out.
RESULTS: The mean age of all patients was 50.5±8.9 years, and 14 of them were female and 11 were male. Among the cases, lower cranial nerve schwannoma accounted for 60 % (15/25) of all tumors, jugular foramen paraganglioma accounted for 20 % (5/25), and the remaining 20 % included meningioma, chondrosarcoma, plasmacytoma, and salivary gland tumors. Total tumor resection was performed in 18 cases, subtotal tumor resection in 7 cases and partial resection in 1 case. Seven patients underwent gamma knife radiotherapy after surgery. Transient lower cranial nerve dysfunction occurred in 8 patients, and permanent lower cranial nerve dysfunction occurred in 2 patients after surgery. One patient developed facial paralysis, and one patient presented hearing loss.
CONCLUSIONS: The postauricular ITFA achieved a relatively high total tumor resection rate and a lower incidence of neurological functional disorders. It is an alternative and suitable surgical approach for resecting jugular foramen lesions. Maximizing the preservation of neurological function is preferred, especially when radical resection cannot be achieved. Stereotactic radiotherapy could be used for residual tumors.
METHODS: All 25 patients undergoing microsurgery via postauricular ITFA from March 2015 to May 2023 in the Department of Neurosurgery, Tangdu Hospital, Air Force Military Medical University were included. The clinical and radiological data were retrospectively analyzed. Regular follow-up was carried out.
RESULTS: The mean age of all patients was 50.5±8.9 years, and 14 of them were female and 11 were male. Among the cases, lower cranial nerve schwannoma accounted for 60 % (15/25) of all tumors, jugular foramen paraganglioma accounted for 20 % (5/25), and the remaining 20 % included meningioma, chondrosarcoma, plasmacytoma, and salivary gland tumors. Total tumor resection was performed in 18 cases, subtotal tumor resection in 7 cases and partial resection in 1 case. Seven patients underwent gamma knife radiotherapy after surgery. Transient lower cranial nerve dysfunction occurred in 8 patients, and permanent lower cranial nerve dysfunction occurred in 2 patients after surgery. One patient developed facial paralysis, and one patient presented hearing loss.
CONCLUSIONS: The postauricular ITFA achieved a relatively high total tumor resection rate and a lower incidence of neurological functional disorders. It is an alternative and suitable surgical approach for resecting jugular foramen lesions. Maximizing the preservation of neurological function is preferred, especially when radical resection cannot be achieved. Stereotactic radiotherapy could be used for residual tumors.
摘要：
目的：本研究的目的是评估耳后颞下窝入路（ITFA）切除颈静脉孔病变的临床效果和安全性。
方法：2015年3月至2023年5月在神经外科接受耳后ITFA显微手术的所有25例患者，唐都医院,包括空军军医大学。回顾性分析其临床和影像学资料。定期随访。
结果：所有患者的平均年龄为50.5±8.9岁，其中14人是女性，11人是男性。在案件中，下颅神经鞘瘤占所有肿瘤的60%(15/25)，颈静脉孔区副神经节瘤占20%(5/25),剩下的20%包括脑膜瘤,软骨肉瘤,浆细胞瘤,和唾液腺肿瘤.18例肿瘤全切除,肿瘤次全切除7例,部分切除1例。7例患者术后行伽玛刀放疗。8例患者出现短暂性下颅神经功能障碍,2例患者术后发生永久性下颅神经功能障碍。一个病人出现了面瘫,一名患者出现听力损失。
结论：耳后ITFA获得了相对较高的肿瘤总切除率和较低的神经功能障碍发生率。这是切除颈静脉孔病变的另一种合适的手术方法。最大限度地保护神经功能是首选，尤其是当无法实现根治性切除时。立体定向放疗可用于残留肿瘤。
方法：2015年3月至2023年5月在神经外科接受耳后ITFA显微手术的所有25例患者，唐都医院,包括空军军医大学。回顾性分析其临床和影像学资料。定期随访。
结果：所有患者的平均年龄为50.5±8.9岁，其中14人是女性，11人是男性。在案件中，下颅神经鞘瘤占所有肿瘤的60%(15/25)，颈静脉孔区副神经节瘤占20%(5/25),剩下的20%包括脑膜瘤,软骨肉瘤,浆细胞瘤,和唾液腺肿瘤.18例肿瘤全切除,肿瘤次全切除7例,部分切除1例。7例患者术后行伽玛刀放疗。8例患者出现短暂性下颅神经功能障碍,2例患者术后发生永久性下颅神经功能障碍。一个病人出现了面瘫,一名患者出现听力损失。
结论：耳后ITFA获得了相对较高的肿瘤总切除率和较低的神经功能障碍发生率。这是切除颈静脉孔病变的另一种合适的手术方法。最大限度地保护神经功能是首选，尤其是当无法实现根治性切除时。立体定向放疗可用于残留肿瘤。
