带蒂颞肌瓣在迷路径路听神经瘤切除后缺损术腔填塞的应用

The application of pedicle temporal muscle cavity packing after the acoustic neuroma labyrinthus pathway flap for resection surgical through

目的探讨带蒂颞肌瓣转移填塞迷路径路听神经瘤切除后骨质缺损术腔的临床应用。方法对16例（耳）经迷路径路听神经瘤切除术后术腔的处理，采用带蒂颞肌瓣转移填塞切除后骨质缺损术腔8耳，采用腹部游离脂肪填塞缺损术腔8耳。结果8耳采用带血管蒂颞肌瓣均未出现脑脊液耳漏，8耳采用腹部游离脂肪填塞者1耳出现脑脊液耳漏，经加压包扎及降低颅内压后脑脊液漏愈合。全部病例均未出现颅内感染，两组在手术时间，头部伤口加压时间和平均住院天数均无显著差别，但颞肌瓣组在同一手术野操作，较为方便。结论带蒂颞肌瓣血供好、手术操作容易、不影响头部美观，是经迷路径路听神经瘤切除后缺损术腔的较好填塞材料。

Objective To investigate the clinical application of pedicle temporal muscle flap for surgical cavity packing after the acoustic neuroma resection through labyrinthus pathway. Methods Sixteen cases （ears） have accepted the acoustic neuroma resection through labyrinthus pathway, 8 surgical cavities were backed with pedicle temporal muscle flap, and 8 surgical cavities were packed with dissociated abdominal fat. Results There are no ncurolymph otorrhea happened in 8 cases which have accepted the pedicle temporal muscle flap. For the other 8 cases which have accepted the dissociated abdominal fat packing, 1 case got the ncurolymph otorrhea after the surgery, and it was cured after forced wrapping and intracranial pressure reduction. There are no intracranial infection occurred in all these cases, and there are no significant differences in operation time, forced wrapping time, and mean days of hospital stay between this two groups, but it＇s convenient to pack the cavity with the pedicle temporal muscle flap compared with the dissociated abdominal fat packing. Conclusion The pedicle temporal muscle flap has good blood supply, and it is much easier to be used during the operation, there is no effect on the head outlook. The pedicle temporal muscle flap can be used as a good packing material after the acoustic neuroma resection through labyrinthus pathway.