大型听神经瘤的显微手术治疗:附45例分析

Microsurgical Management of Large Acoustic Neuromas

背景与目的:听神经瘤为常见颅内良性肿瘤之一,治疗以手术为主,本文探讨经枕下-乙状窦后(Suboccipital retrosigmoid approach,SO)入路显微手术治疗大型听神经瘤的操作技巧及治疗效果。方法:回顾性分析经枕下-乙状窦后入路显微手术治疗的45例大型听神经瘤。结果:本组肿瘤全切40例(88.9%),次全切除5例(11.1%)。面神经解剖学保留率为86.7%(39例)。对40例进行1年以上的随访评估,面神经功能获得满意恢复者为32例(71.1%)。结论:经枕下-乙状窦后入路显微手术切除大型听神经瘤,面神经可获得解剖学与功能的保护,能明显降低并发症与病死率。

BACKGROUND ＆ OBJECTIVE： To investigate the surgical techniques and results of large acoustic neurom by suboccipital retrosigmoid approach. METHODS： Forty-five patients with large acoustic neuroma treated with microsurgery by suboccipital retrosigmoid approach were retrospectively analyzed. RESULTS： Total tumor removal was achieved in 40 cases（88.9%） and subtotal removal in 5 cases（11.1%）.Facial nerves were preserved anatomically in 39cases （86.7%） of the patients. Facial nerve function were preserved in 32cases（71.1%） at one year follow-up assessment. CONCLUSIONS： Microsurgical techniques for removing large acoustic neuroma by suboccipital retrosigmoid approach resulted in satisfactory anatomical and functional preservation of the facial nerves with low morbidity and mortality.