电生理监测下切除大型听神经瘤临床研究

The application of electrophysiologic detection in the microsurgical treatment for large acoustic neuromas

目的探讨电生理监测在大型听神经瘤手术中的应用价值。方法对52例显微手术治疗的大型听神经瘤患者资料进行回顾性分析,比较监测组和未监测组术后面神经保留情况。结果全部病例中肿瘤全切除44例(84.6%),次全切除6例(11.5%),大部切除2例(3.8%)。监测组面神经解剖保留27例(93.1%),未监测组18例(78.3%)。监测组术后6个月面神经功能保留(H-B分级Ⅰ、Ⅱ级)21例(72.4%),未监测组11例(47.8%)。监测组面神经解剖保留率和功能保留率均明显高于未监测组(P<0.05)。结论术中面神经电生理监测可以提高面神经解剖和功能保留率。

Objective To investigate the application of electrophysiologic detection in the microsurgical treatment for large acoustic neuromas. Methods 52 cases of large acoustic neuromas treated with microsurgery were analyzed. The facial nerve preservation was compared between intraoperative facial nerve monitoring patients （ IFNM group） and no intraoperative nerve facial monitoring patients （ NIFNM group）. Results 44 cases （84.6%） achieved total resection, 6 cases （ 11.5% ） achieved subtotal resection and 2 cases（3.8% ） achieved partial resection. The anatomically preservation of facial nerve in IFNM group and NIFNM group was 27（93.1% ）, 18（78.3% ） respectively. According to the House-Brack- mann facial nerve grading system, 21 cases （72.4%） in IFNM group got preserve of facial nerve function 6 months after operation, compared with 11 cases （47.8%） in NIFNM group. The anatomic and functional preservation rates of facial nerve in the IFNM group were both higher than that of NIFNM group （P 〈 0.05）. Conclusion IFNM can increase the rates of total tumor resection and facial nerve preservation in the operation of large acoustic neuromas.