面神经在大型听神经瘤中的分布变化规律

Anatomic location of facial nerve in large vestibular schwannomas

目的探讨大型听神经瘤术中面神经与听神经瘤的相对解剖位置及规律。方法通过回顾性分析133例大型听神经瘤的手术录像，分析面神经在听神经瘤的中的分布变化规律。结果面神经在脑干端和内听道基底部的位置相对固定，在可识别面神经的病例中，在内听道口前上部有35例（26％），前下部的89例（67％），后下部6例（5％）。在小脑脑桥角池中段位于肿瘤前上方11例（8％），前中部49例（37％），前下部63例（47％），后下部6例（5％）。结论掌握面神经在大型听神经瘤中的分布规律可以提高面神经的保护。

Objective To explore the anatomic relation between facial nerve and large vestibular schwannoma. Method The anatomic relation between facial nerve and large vestibular schwannoma was analyzed by retrospective analysis of surgery videoes of 133 cases. Results The location of facial nerve was relatively fixed at internal auditory canal base and pons. At the porus, the facial nerve was found on the anterior superior direction in 35 （26%）, anterior inferior in 89 （67%）, posterior inferior in 6 （5%）. In cerebellopontine angle, the faeial nerve was found on the anterior superior 1/3 portion of the tumor in 11 （ 8% ） , anterior middle 1/3 in 49 cases （ 37% ） , anterior inferior 1/3 in 63 （ 47% ）. The posterior location was rare and was found in only 6 eases（5% ）. Conclusions Knowledge of facial nerve distribution could help to improve anatomic and functional preservation of facial nerve in large vestibular schwannoma operation.