神经内镜辅助显微手术与常规显微手术对囊性听神经瘤患者的疗效及对House-Brackmann面神经功能的影响

Efficacy of Neuroendoscopy-assisted Microsurgery and Conventional Microsurgery in the Resection of Cystic Acoustic Neuroma and the Effects on House-Brackmann Facial Grading

目的 研究比较神经内镜辅助显微手术与常规显微手术治疗囊性听神经瘤患者的效果及对House-Brackmann面神经功能的影响。方法 选取180例囊性听神经瘤患者作为研究对象,根据患者的手术方案分为实验组(n=90)和对照组(n=90),对照组接受常规显微手术治疗,实验组接受神经内镜辅助显微手术。对比两组患者肿瘤切除率、两组患者治疗后House-Brackmann面神经功能,两组患者治疗前后疼痛程度,两组患者并发症发生率。结果 实验组全切除率[97.77%(88/90)]显著高于对照组[90.00%(81/90)](P<0.05);实验组Ⅰ级患者显著高于对照组,Ⅱ级患者显著低于对照组(P<0.05);治疗后,两组患者视觉模拟评分法(VAS)评分均降低,且相比于对照组,实验组显著更低(P<0.05);实验组并发症发生率[2.22%(2/90)]显著低于对照组[2.22%(2/90)](P<0.05)。结论 相比于常规显微手术,神经内镜辅助显微手术效果更为显著,对于患者面神经影响较低,安全性更高。

Objective To compare the efficacy of neuroendoscopy-assisted microsurgery and conventional microsurgery in the resection of cystic acoustic neuroma and their effects on House-Brackmann facial grading.Methods A total of 180 patients with cystic acoustic neuroma were enrolled, and divided into 2 groups according to different treatment regimes, each with 90 cases.The control group received conventional microsurgery, while the experimental group received neuroendoscopy-assisted microsurgery.Then the total resection rate, House-Brackmann facial grading, pain degree and complication rate were compared between the 2 groups.Results The total resection rate was 97.77%(88/90) in the experimental group, which was significantly higher than 90.00%(81/90) in the control group, with statistical difference(P<0.05).Compared with the control group, the experimental group had higher proportion of House-Brackmann facial grade Ⅰ patients and lower proportion of House-Brackmann facial grade Ⅱ patients, with statistical difference(P<0.05).Visual Analogue Scale score was significantly decreased in both groups after treatment(P<0.05),and the decrease was more significant in the experimental group than in the control group(P<0.05).The complication rate was 2.22%(2/90) in the experimental group, which was significantly lower than 2.22%(2/90) in the control group, with statistical difference(P<0.05).Conclusion Compared with conventional microsurgery, neuroendoscopy-assisted microsurgery in the resection of cystic acoustic neuroma achieves better efficacy and higher safety, without affecting the facial nerve function.