听神经瘤分期及治疗效果分析

Classification of acoustic neuroma size and its relations to the treatment outcomes

目的探讨听神经瘤分期方法及其与手术效果的关系。方法回顾分析1999～2003年收治的109例听神经瘤病例，按肿瘤大小分为1～5期，3例采用观察方法，106例分别采用扩大迷路进路、乙状窦后进路及颅中窝进路等手术治疗，根据肿瘤切除程度、面神经功能保留程度、听力保留程度等评估手术结果。结果肿瘤全切率为95％(101／106)；面神经保留率96％（102／106)，迷路进路或扩大迷路进路患者面神经功能优良率(1～2级)为56％，可接受率(1～4级)为86％：听力保存率为42％。结论听神经瘤的统一分期可以帮助选择治疗方案、评估手术效果，对临床治疗工作有重要指导意义。

OBJECTIVE To evaluate the classification of acoustic neuroma size and its relations to the treatment outcomes. METHODS 109 acoustic neuromas which were treated between 1999-2003 were analyzed. The tumors were classified into 1 ~5 stages according to its largest diameter. Some cases were observed with MRI follow-up. Three approaches were used in this series, including trans-labyrinthine approach, middle fossa approach and retro-sig-moid approach. RESULTS Total tumor removal was achieved in 95 % cases. The facial nerves were preserved in 102 cases, The interruption of nerve occoured in 4 cases. The hearing was preserved in 42 % cases. CONCLUSIONS The classification of acoustic neuroma could help in deciding the treatment strategy, evaluating the treatment outcomes and comparing the data from different centers.