听神经瘤的微骨窗手术切除面神经保护技术探讨

Technology of facial nerve protection in removal of acoustic neuroma by small bone window surgery

目的探讨听神经瘤微骨窗切除手术中保护面神经的技术,同时对解剖保留的面神经的功能进行进一步评价。方法 130例听神经瘤患者在面神经监测下手术,治疗完成后对手术情况、神经功能分级、术后刺激强度与神经功能预后情况以及并发症发生情况进行评价。结果 130例患者中118例(90.8%)无神经功能障碍,9例(6.9%)存在一定的神经功能障碍,2例(1.5%)存在严重的神经功能障碍,1例(0.8%)生活不能自理。神经功能分级Ⅰ、Ⅱ级60例(47.6%),Ⅲ、Ⅳ级43例(34.1%),Ⅴ、Ⅵ级23例(18.3%)。结论听神经瘤手术时,通过对面神经的监测以及提高手术的熟练度,能够加强对面神经的保护。

Objective To discuss the technology of facial nerve protection in removal of acoustic neuroma by small bone window surgery and evaluate the function of the facial nerve.Methods One hundred and thirty patients with this disease were treated under facial nerve monitoring.After the treatment,the operation situation,nerve function classification,stimulus intensity and neural functional prognosis were evaluated.Results 118（90.8%）cases had no neurological dysfunction,9（6.9%）cases had certain nerve dysfunction,2（1.5%）cases had severe nerve dysfunction,and 1（0.8%）case could not live on one＇s own.In nerve function,60（47.6%）cases were grade Ⅰ and Ⅱ,43（34.1%）cases were grade Ⅲ and Ⅳ,23（18.3%）cases were gradeⅤ and Ⅵ.Facial nerve function was correlated with postoperative stimulus intensity.The greater the stimulation intensity,the more difficult the facial nerve recovered.Conclusion During the acoustic neuroma surgery,the nerve monitoring and improvement of the proficiency of the operation can strengthen the protection of the nerve.