术中神经电生理监测技术对大、中型听神经瘤术后面神经保护的影响

The facial nerve preservation of intraoperative facial nerve monitoring in large and huge acoustic neuroma resection

目的探讨神经电生理监测技术对大、中型听神经瘤面神经术后保留的意义。方法回顾性分析宁夏医科大学总医院手术治疗99例听神经瘤患者,其中经枕下乙状窦后入路显微外科切除肿瘤过程中使用术中神经电生理监测(监测组)49例,直接显微镜下切除肿瘤(非监测组)50例,观察2组患者术后面神经解剖及功能保留率的情况。结果术后2周内按House-Brackmann面神经功能分级标准,监测组与非监测组术后功能保留率分别为21例(42.9%)、12例(24%)。结论术中面神经电生理监测的广泛应用,可显著提高听神经瘤患者术后面神经的解剖保留率和功能保留率。

Objective To explore the clinical significance of intraoperative nerve monitoring for facial nerve preservation during the large and medium acoustic neuroma. Methods 99 cases of neurosurgical acoustic neuroma surgery with the patients clinical dates were retrospectively analyzed. Microscopic resection was used in tumor surgery of facial nerve monitor nerve monitoring（ monitoring group） in 49 patients,and directly remove tumor 50 cases（ non- monitoring group） and analyze the possible prognostic factors of facial nerve preservation. Results Patients who were evaluated after 2 weeks of facial nerve function status,and scored by House- Braekmann. Total resection rate of acoustic neuroma,the facial nerve function retention rate of the monitoring group were 21 patients（ 42. 9%）,while the non- monitoring group was in 12 patients（ 24%）. Conclusion Intraoperative nerve monitoring is effective in increasing the rate of the facial neurotomia retention rate and facial nerve function retention for acoustic neuroma.