Clinical analysis of the treatment of foramen magnuin tumors with the posterior median approach

doi:10.3877/cma.j.issn.2095-123X.2020.01.006

Abstract

Abstract:

Objective

To analyze the clinical effect of suboccipital posterior median approach in the treatment of foramen magnum tumors.

Methods

Retrospective analysis of 16 cases of tumors in the occipital foramen region from January 2012 to January 2019 were resected by microsurgery combined with cavitron ultrasonic surgical aspirator through posterior median approach. Among them, 5 cases were neurofibromas, 7 cases were meningiomas, and 4 cases were hemangioblastomas. The curative effect of 16 cases was observed.

Results

Among the 16 cases, 14 cases of forarnen magnum tumors were totally resected and 2 subtotally resected. Posterior cranial nerve injury was aggravated in 2 postoperative cases and no death case was found. The follow-up period was 3 months to 7 years. Except for 1 patient who still had limb weakness and unstable walking after operation, the symptoms of the remaining patients disappeared. One case of subtotal resection relapsed 3 years after the operation.

Conclusion

The microsurgical resection of foramen magnum tumors requires a high level of surgical skills, and it is very important to protect the brain stem, posterior cranial nerves and vascular during operation. The posterior median approach can be widely used for surgical treatment of tumors in the occipital foramen area.

Key words: Foramen magnum tumor, Microsurgery, Posterior median approach

Yehai Li, Jianhao Lin, Jing Ye, Guilu He, Ruirui Yun, Fobao Huang, Qiao Li, Liang Zhang. Clinical analysis of the treatment of foramen magnuin tumors with the posterior median approach[J]. Chinese Journal of Brain Diseases and Rehabilitation(Electronic Edition), 2020, 10(01): 25-29.

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References 21

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例序	性别	年龄（岁）	病程（月）	分型	肿瘤直径(cm)
1	男	49	5	Ⅱa	3.6
2	女	28	6	Ⅰa	3.2
3	女	19	12	Ⅱa	5.8
4	男	43	24	Ⅱa	4.9
5	女	51	48	Ⅱa	4.0
6	女	62	2	Ⅱa	5.1
7	女	49	8	Ⅰa	3.2
8	男	11	4	Ⅱa	4.3
9	女	26	8	Ⅱa	3.8
10	男	46	7	Ⅰa	5.7
11	女	39	15	Ⅱa	4.4
12	女	55	10	Ⅰa	3.0
13	男	22	3	Ⅰa	3.4
14	女	41	4	Ⅱa	3.3
15	男	32	13	Ⅱa	6.0
16	女	27	1	Ⅰa	4.5

例序	性别	年龄（岁）	病程（月）	分型	肿瘤直径(cm)
1	男	49	5	Ⅱa	3.6
2	女	28	6	Ⅰa	3.2
3	女	19	12	Ⅱa	5.8
4	男	43	24	Ⅱa	4.9
5	女	51	48	Ⅱa	4.0
6	女	62	2	Ⅱa	5.1
7	女	49	8	Ⅰa	3.2
8	男	11	4	Ⅱa	4.3
9	女	26	8	Ⅱa	3.8
10	男	46	7	Ⅰa	5.7
11	女	39	15	Ⅱa	4.4
12	女	55	10	Ⅰa	3.0
13	男	22	3	Ⅰa	3.4
14	女	41	4	Ⅱa	3.3
15	男	32	13	Ⅱa	6.0
16	女	27	1	Ⅰa	4.5

例序	切除程度	病理诊断	放射治疗	复发	KPS评分
1	全切除	脑膜瘤	否	否	100
2	全切除	血管母细胞瘤	否	否	100
3	全切除	神经鞘瘤	否	否	80
4	全切除	神经鞘瘤	否	否	90
5	全切除	脑膜瘤	否	否	100
6	次全切除	脑膜瘤	是	否	80
7	全切除	神经鞘瘤	否	否	100
8	全切除	血管母细胞瘤	否	否	90
9	全切除	神经鞘瘤	否	否	100
10	全切除	脑膜瘤	否	否	90
11	次全切除	脑膜瘤	是	复发	50
12	全切除	神经鞘瘤	否	否	100
13	全切除	血管母细胞瘤	否	否	100
14	全切除	脑膜瘤	否	否	90
15	全切除	血管母细胞瘤	否	否	90
16	全切除	脑膜瘤	否	否	90

例序	切除程度	病理诊断	放射治疗	复发	KPS评分
1	全切除	脑膜瘤	否	否	100
2	全切除	血管母细胞瘤	否	否	100
3	全切除	神经鞘瘤	否	否	80
4	全切除	神经鞘瘤	否	否	90
5	全切除	脑膜瘤	否	否	100
6	次全切除	脑膜瘤	是	否	80
7	全切除	神经鞘瘤	否	否	100
8	全切除	血管母细胞瘤	否	否	90
9	全切除	神经鞘瘤	否	否	100
10	全切除	脑膜瘤	否	否	90
11	次全切除	脑膜瘤	是	复发	50
12	全切除	神经鞘瘤	否	否	100
13	全切除	血管母细胞瘤	否	否	100
14	全切除	脑膜瘤	否	否	90
15	全切除	血管母细胞瘤	否	否	90
16	全切除	脑膜瘤	否	否	90

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