枕下乙状窦后入路显微手术切除86例听神经鞘瘤临床分析

Clinical Analysis of Microsurgical Operation in Suboccipital Retrosigmoid for 86 Cases of Acoustic Neurinoma

目的总结听神经鞘瘤的显微手术技巧及治疗策略.方法回顾性分析86例患者的手术过程及预后,对术中技巧、神经保护、血管保护及术后治疗等方面进行比较分析.结果患者均为单侧肿瘤,全切78例;次全切8例;术后死亡1例.术后面神经House-Brackmann分级评测:I^II级71例;III^IV级11例;V^VI级3例;死亡未评测1例.结论娴熟的手术技巧、肿瘤切除的方式以及血管的保护在肿瘤切除及面神经保护中尤为重要.

Objective To summarize the technique and treatment strategy of microscopic operation in patients with schwannoma.Method We retrospectively analyzed the operation and prognosis of 86 cases of schwannoma,and carried on the comparative analysis of surgical skills, neural protection, protection of blood vessels and postoperative therapy.Results All 86 patients were unilateral tumor,78 cases accepted total resection,8 cases accepted subtotal resection,1 cases died after operation. Postoperative facial nerve House-Brackmann Grading-71 cases were grade I-II, 1 cases were grade III-IV, 3 cases were grade V-VI, 1 case died without evaluation.Conclusion Skilled surgical technique,tumor resection way and vascular protection are particularly important in tumor resection and facial nerve protection.