侧颅底肿瘤外科与听觉功能保护

Lateral Skull Base Surgery and Hearing Preservation

侧颅底区域上承颅脑,下接颈部,其间穿行重要的血管、神经、位听器官,解剖结构复杂。切除病变同时保留重要组织器官功能是侧颅底外科的基本原则,在神经医学、介入医学、面神经外科发展的基础上,颅底重要神经、血管的保护已经取得显著进步,致命并发症及其他神经功能缺失发生率已显著降低,而听觉功能保护目前尚不理想,如何进一步保护听觉功能逐渐成为研究热点。选择正确治疗方式、恰当的手术入路、内镜技术的应用、术中听觉电生理监测以及术中听觉功能重建等对于听觉功能保护非常重要。

The anatomy of the lateral skull base is very complicated,which supports the brain upwards and connects the neck downwards with a large number of crucial structures passing through,including important blood vessels,nerves,and vestibular and auditory apparatuses. The basic principle of lateral skull base surgery is resecting the lesion and meanwhile preserving the function of important tissue and organs. With the development of interventional medicine,neuromedicine and facial nerve surgery,protection of important nerves and blood vessels of the skull base has made significant progress,and fatal complications and neurological defects have been greatly reduced. However,the protection of auditory function is not ideal,which has gradually become a research hotspot. The selection of appropriate treatment and surgical approach,the usage of endoscopic techniques,intraoperative auditory electrophysiology monitoring,and intraoperative reconstruction of the auditory function are all very critical for hearing protection.