显微手术切除大型听神经瘤

Microsurgical removal of large acoustic neuromas

目的 探讨应用显微外科技术切除大型听神经瘤 (直径≥ 31mm)的治疗效果。 方法 大型听神经瘤经 CT或 MRI扫描检查确诊 ,应用显微外科技术、经枕下 -乙状窦后入路行肿瘤切除术2 2 8例。 结果 全切除 184例 (80 .7% ) ,次全切除 33例 (14.5 % ) ,部分切除 11例 (4 .8% )。术中面神经解剖保留率为 82 .9% (189例 ) ,术后死亡 3例 (1.3% )。长期随访观察 2 0 1例 (平均 3.8年 ) ,其中恢复良好者 189例 (94.0 % )。 结论 采用显微外科技术切除大型听神经瘤是一种安全。

Objective To probe the effect of using microsurgical removal of large acoustic neuroma (diameter:≥31 mm) Methods A total of 228 patients suffering from large acoustic neuroma were diagnosed by CT or MRI scanning in our department The tumors were removed via suboccipito retrosigmoid approach under a microscope Results The gross total removal of tumor was achieved in 184 patients (80 7%),and subtotal removal in 33 patients (14 5%) Partial removal was carried out in the remaining 11 patients (4 8%) The anatomic preservation of facial nerve was achieved in 189 patients (82 9%) There were three patients (1 3%) deaths after surgery Long term follow up observation (median:3 8 years) in 201 patients revealed good recovery in 189 (94 0%) Conclusion Microsurgical technique via suboccipito retrosigmoid approach is a safe and effective way to remove large acoustic neuroma