听神经瘤显微手术治疗和面听神经功能保护的探讨

Microsurgery of acoustic neuroma with facial and acoustic nerve preservation

目的探讨听神经瘤显微手术治疗和面听神经功能保护的疗效。方法分析1999年10月至2002年10月收治经枕下乙状窦后内听道入路手术切除30例听神经瘤的资料,全部病例采用保留面听神经功能的显微外科技术。结果听神经瘤手术全切除29例(96.7%),次全切除1例;面神经解剖保留25例(83.3%),手术后12周面神经功能保留21例(70%);耳蜗神经解剖保留25例83.3%),手术后2周有效听力保留2例(占术前存在有效听力患者的28.6%),有效听力丧失但可测听力保留15例。结论枕下乙状窦后经内听道入路的听神经显微手术,能够取得较好的肿瘤全切除率和面听神经功能保留率。

Objective To discuss the microsurgical effects of acoustic neuroma with tacial and acoustic nerve preservation. Methods The data of 30 patients of acoustic neuroma with facial and hearing peservation microsurgery undergoing retrosigmoid approach from Oct. 1999 to Oct. 2002 were collected. Results Total acoustic neuroma removal was in 29 patients （96.7%）, subtotal tumor removal was in 1 patient. Facial nerve anatomic preservation was in 25 patients（83.3% ）, facial nerve function preservation was in 21 patients（70% ） in 12 weeks postoperatively. Cochlear nerve anatomic preservation was in 25 patients （83.3%） during operation, useful hearing preservation was in 2 patients in 2 weeks postoperatively（ account for 28.6% of all patients with useful hearing preoperatively） , measurable but not useful hearing preservation was in 15 patients. Conclusion Undergoing retrosigmoid approach one can succeed to get high rate of total acoustic neuroma removal, facial and hearing preservation.