听神经瘤的手术治疗分析

Analysis of diagnosis and surgical treatment of 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。方法将全部的45例患者都采用枕下乙状窦后入路,显微手术切除肿瘤,14例采用内镜辅助下切除。结果本组45例中,全切除40例,次全切5例,肿瘤全切除率88.9%;面神经功能保留33例。术后听力减退或加重9例,出现面部麻木6例,面瘫l1例,经随访6个月～2年,听力减退恢复6例,面部麻木恢复4例,面瘫恢复7例。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 investigate the pillow next generations microsurgery sigmoid sinus surgery operation of large acoustic neuromas and treatment techniques.Methods Totally 45 patients all have adopted the suboccipital retrosigmoid approach,microsurgical resection of the tumor,14 patients with endoscopic-assisted resection.Results Of the 45 cases,40 cases of total resection,subtotal in 5 cases.Complete resection rate was 88.9%;33 cases of facial nerve function preservation.After hearing loss,or increased in 9 cases,6 cases occurred facial numbness,facial paralysis l1 cases,which were followed up for 6 months to 2 years,6 cases of hearing loss recovery,restore facial numbness,4 cases of facial paralysis recovery in 7 cases.Conclusions The descendants of sigmoid sinus pillow next microsurgical removal of large acoustic neuroma,facial nerve anatomy and function of the protection available,can significantly reduce morbidity and mortality.