192例听神经瘤术中神经电生理监测

IIntraoperative electrophysiological monitoring offacial nerve during vestibular Schwannomasurgery: An experience of 192 cases

目的探讨听神经瘤术中电生理监测技术常见问题的处理,提高面神经解剖保留率。方法 192例听神经瘤患者手术时均在面神经电生理监测下进行,采用枕下乙状窦后经内听道入路,显微外科切除肿瘤,术后对面神经功能进行评估。结果肿瘤全切1 8 3例(95.3%),面神经完整解剖保留185例(96.4%)。长期随访病例面神经功能良好率83.0%,术中F波监测结果与术后面神经功能之间有较好的一致性。结论听神经瘤术中神经电生理监测的运用可明显提高面神经的解剖保留率和功能保留优良率,术中F波监测不仅可实时反馈面神经功能状态,而且可为术后面神经功能的预测提供依据。

Objective To investigate the management of common problems of intraoperative facial nerve monitoring and to improve the function protection of facial nerve during vestibular Schwannoma surgery.Methods 192 patients underwent microsurgical resection of vestibular Schwannomas through suboccipital retrosigmoid approach with intraoperative facial nerve monitoring.Facial nerve function was assessed postoperatively.Results Of all the 192 cases,total resection of tumor was achieved in 183 cases（95%）.Facial nerve was preserved anatomically in 185 cases（96.4%）.Long term follow up revealed good outcome of facial nerve function（92.4%）.Conclusion Intraoperative nerve monitoring can effectively increase the preservation rate of facial nerve anatomically and functionally.