枕下入路显微手术切除大型听神经瘤

Microsurgical Resection of Large Acoustic Neuromas via Suboccipito-retrosigmoid Approach

目的 探讨显微手术切除大型听神经瘤的入路和方法。方法 经枕下入路显微手术切除大型听神经瘤33例。结果全切除29例,次全切除4例,无术后血肿、CSF漏及空气栓塞发生,无死亡;随访2月～4年,均能参加正常工作和学习,遗留永久性面瘫3例。结论 枕下乙状窦后入路显微手术是大型听神经瘤的最佳入路和方法,并能较好的保留听、面神经功能。手术应强调仔细、耐心操作。

Objective To study the approach and methods of the microsurgical resection of large acoustic neuromas. Method The large acoustic neuromas were microsurgically removed via suboccipitol-retrosigmoid appoach in 33 patients. Results Of 33 cases of the large acoustic neuromas, 29 were totally resected and 4 subtotally. There were no postoperative haematoma, air embolism and death. Follow up for 2 months to 4 years showed that all the patients could normally work and study, but 3 patients had facial paralysis. Conclusions Microsurgical operation via the suboccipito-retrosigmoid approach is the best way of treating the large acoustic neuromas and can well protect the function of the acoustic and facial nerves.