大型听神经瘤的显微手术治疗

Microsurgical treatment of large acoustic neurinomas

目的探讨显微手术切除大型听神经瘤的入路和方法。方法经枕下入路显微手术切除大型听神经瘤65例,其中锁孔手术10例。结果全切除58例,次全切除7例,无死亡,出现术后血肿1例。随访2个月～5年,均参加正常工作和学习,遗留永久性面瘫5例。结论枕下入路显微手术是大型听神经瘤的最佳入路和方法之一,能较好地保留听、面神经功能。锁孔手术完全可以达到切除大型听神经瘤要求。

Objective To study approach and methods of microsurgical treatment for large acoustic neurinomas. Methods Microsurgical removal of large acoustic neurinomas was performed in 65 cases via suboccipito-retrosigmoid approach (key hole in 10 cases). Results Total resection was achieved in 58 cases, and subtotal resection was in 7 cases. There was 1 case experienced a postoperative haematoma. There is no death. Follow-up period was from 2 monthes to 5 years. All of the patients returned to their normal work and study, only 5 patients with facial paralysis left. Conclusion Microsurgical resection via suboccipito-retrosigmoid approach is the best approach for large acoustic neurinomas. Meticulous and patient manipulation should be emphasized in order to preserve the facial nerve. Keyhole approach is suitable for resecting large acoustic neurinomas.