大型听神经瘤的显微手术治疗

Microsurgical Management of Large Acoustic Neuroma

目的探讨经枕下-乙状窦后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例大型听神经瘤临床资料。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,对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。

Objective To evaluate the diagnosis of the large acousticneuroma, microsurgical resection via＇ a suboccipital retrosigmoid approach and prognosis. Methods A retrospective analysis of 45 patients with large acoustic neuroma was performed, and they were treated via suboccipital retrosigmoid approach. Results Total tumor removal was achieved in 40cases （88.9%） and subtotal tumor removal in 5cases （11.1%）. The facial nerve was preserved anatomically in 39cases （86.7%） of the patients. Facial nerve function were obtained in 32cases （71.1%） by the time of follow-up assessment one year later. Conclusion Using of the microsurgical techniques for removing large acoustic neuromas results in good anatomical and functional preservation of the facial nerve,with minimum incidence of morbidity and low mortality.