脳底部に発生したepidermoidの2手術治験例—われわれの開頭皮切法の紹介

TWO CURED CASES OF EPIDERMOID ON THE SKULL BASE:Our Surgical Approach

I．はじめに

　最近われわれは天幕の上下に跨り頭蓋底に存在したepidermoid 2例を経験した。2例とも摘出に成功し，現在有意の生活を送つているので特にその手術，開頭法について報告する。

There are reported two cases of epidermoid on the skull base with successful removal by a new ap-proach.

Case 1 was a 38-year-old man, who complained of hardness to hear and facial palsy on the right side. A shift of the basilar artery to the left side was revealed by a vertebral angiography. Pneumo-and-myosil ventriculography disclosed a upwards shift of aqueductus mesencephali, suggesting a large tumor occupied both supra-and-infra tentrium over the skull base.

A operation was carried out under hypothermic anesthesia of 28℃. The patient was placed in a prone position with head slightly flexed. A curved incision as like as question mark from the external occipital protuberance, sliding down on the inside of the mastoid was made. After the skin flap was flexed medially, the sinus transversus and the ten-trium was cut.

In this method, we can obtain a wide operation's field. Moreover, when occipital lobe and cerebellar hemisphere was elevated and retracted medially, we can inspect the geniculate body, cerebral peduncle, and pontine region.

Case 2 was 40-year-old man whose complaints was trigeminal neuralgia on the left side. A operation was performed with the total removal of the tumor on the left pontine angle.

Characteristic symptomes and signs of epidermoid were also discussed here in details.