神经电生理检测下手术治疗囊性前庭神经瘤手术的效果评价

The Evaluation of the Effect of Electrophysiological Detection on the Surgical Treatment of Cystic Vestibular Neuroma

目的:评价神经电生理监测下囊性前庭神经鞘瘤手术效果。方法:回顾性分析66例囊性前庭神经鞘瘤病例的临床资料。所有患者在麻醉插管后行侧卧位,术中行神经电生理监测,经枕下乙状窦后入路显微手术切除肿瘤。结果:本组肿瘤全切除例44例,次全切除(切除程度≥90%) 15例;面神经解剖保留31例,听力保留12例。术后1个月根据(H-B)标准评估:Ⅰ级9例,Ⅱ级13例,Ⅲ级21例,Ⅳ级16例,Ⅴ级8例。术后发热15例,经对症处理后好转。术前三叉神经症状9例,均术后改善,无死亡病例。结论:在神经电生理监测下,经枕下乙状窦后入路,显微手术切除囊性前庭神经鞘瘤效果满意。值得临床进一步研究。

Objective：To evaluate the smgical effect of neuroelectrophysiological detection monitoring on cystic vestibular neuroma. Methods ： The clinical data of 66 cases of cystic vestibule neuroma were analyzed retrospectively. All the patients were placed in the lateral position after anesthesia intubation. Under the intraoperative neurophysiological monitoring, the tumor was removed through the posterior occipital retrosigmoid sinus approach. Results：The total tumor resection were 44 cases cases） ; subtotal hysterectomy （removal of more than 90% ）were 15 cases; the facial nerve was preserved in 31 cases; hearing preservation in 12 cases. One month after the operation, according to （H -B） criteria： Grade I 9 cases, grade II 13 cases, grade III 21 cases, grade IV 16 cases, grade V 8 cases. After operation, 15 cases of fever we~ t^ated with symptomatic tratment. 9 cases of trigeminal nerve symptom before operation were all improved after operation, and no death cases were found. Conclusions：The effect of microsurgical trsection of vestibule neuroma under the neuroelectrophysiological monitoring is satisfactocy by the posterior approach of the suboccipital retrosigmoid si- nus. It is worthy to develop the application in the clinical practice.