神经内镜辅助与单纯显微镜下听神经瘤切除术的疗效比较

Comparison of the therapeutic efficacy between endoscope-assisted and pure microscopic resection in acoustic neuroma surgery

目的比较神经内镜辅助与单纯显微手术治疗听神经瘤的效果差异。方法回顾性分析2019年1月至2022年7月南京医科大学第一附属医院神经外科行听神经瘤切除患者的临床资料,按照手术方式的不同分为观察组(显微镜+内镜辅助组)28例与对照组(显微镜组)44例,比较两组肿瘤全切率、内听道后唇磨除范围、术后并发症率、术前及术后6个月面神经功能情况(House-Brackmann分级)。结果观察组与对照组相比,肿瘤全切率及术后面神经功能障碍率,差异无统计学意义(P>0.05);观察组的内听道后唇磨除范围直径(5.70±0.58)mm低于对照组(6.70±0.58)mm,并发症发生率(7.14%)低于对照组(27.3%),差异均有统计学意义(P<0.05)。结论神经内镜辅助显微手术治疗听神经瘤可以减少内听道后唇的磨除范围,从而减少并发症的发生。

Objective To compare the efficacy of endoscope-assisted and pure microsurgery on acoustic neuroma.Methods The clinical data of 72 patients with acoustic neuroma admitted to the Neurosurgery Department of The First Affiliated Hospital of Nanjing Medical University from January 2019 to July 2022 were retrospectively analyzed.The patients were divided into an observation group(endoscope-assisted+microsurgery)(28 cases)and a control group(microsurgery)(44 cases)according to different surgical methods.The tumor resection rate,the range of the removal of the posterior lip of the internal auditory canal,the postoperative complication rate,and the facial nerve function(House-Brackmann grade)before and 6 months after operation were compared between the two groups.Results There was no significant difference between the observation group and the control group in total tumor resection rate and postoperative nerve function rate(P>0.05);The removal range of the posterior lip of the internal auditory canal in the observation group(5.70±0.58 mm)was significantly smaller than that in the control group(6.70±0.58 mm)and the incidence of complications in the observation group(7.14%)was significantly lower than that in the control group(27.3%),and the difference was statistically significant(P<0.05).Conclusions Endoscope-assisted microsurgery can reduce the abrasion range of the posterior lip of the internal auditory canal,thus reducing the occurrence of complications.