听神经鞘瘤的显微外科治疗

Microsurgical management of the acoustic neurinoma

目的 探讨显微手术切除小脑脑桥角区听神经鞘瘤 (AN)的治疗效果。方法 对经CT或MRI证实、位于小脑脑桥角区的 42 5例AN ,采用显微手术切除 ,术后评估治疗效果 ,分别比较术前、术后的面神经和听神经功能。结果 肿瘤全切率 88.71% (377例 ) ;次全切除率 8.2 4% (35例 ) ;部分切除率 3.0 9% (13例 ) ;术后死亡率 1.41%(6例 )。对 382例平均随访 4.3年 ,其中 2 93例恢复良好 ,6 4例恢复较好 ,2 5例恢复较差 ,后者中有 12例肿瘤复发 (再次手术治疗后治愈 )。结论 采用显微外科技术切除小脑脑桥角区听神经鞘瘤是一种安全、有效的方法。

Objective To probe the treatment effects of the acoustic neurinoma (AN) in cerebellopontine angle using microsurgical techniques. Methods A total of 425 patients suffering from AN in cerebellopontine angle were confirmed by CT or MRI. Each tumor was removed with the microsurgery. Treatment results were evaluated and the preoperative and postoperative function of facial nerve and acoustic nerve were compared respectively. Results The tumors were totally removed in 377 cases ( 88.7%), subtotally removed in 35 cases ( 8.2%) and partially removed in 13 cases ( 3.1%). Six patients ( 1.4%) died after surgery. Long-term follow-up observation (median: 4.3 years) of 382 patients revealed good recovery in 293 patients, fairly good recovery in 64 patients and poor recovery in 25 cases. 12 cases recurred in th 25 cases of poor recovery (cured by the second operation). Conclusion It is a safe and effective way to remove AN in cerebellopontine angle using the microsurgical techniques.