听神经瘤显微手术保留面神经的经验

目的 探讨听神经瘤显微外科手术中面神经保留技术。方法 回顾性研究采用枕下乙状窦后经内耳道入路显微手术治疗的74例听神经瘤，对肿瘤的临床表现和影像学特征、面神经与肿瘤的病理解剖关系以及显微手术技巧进行系统分析。结果 肿瘤手术全切除72例，近全切除2例，面神经解剖保留67例，解剖未能保留7例，其中4例行颅内离断的面神经端-端吻合，术后无死亡病例。结论 显微神经外科技术是全切除听神经瘤安全有效的方法，熟悉面神经与肿瘤的病理解剖关系对于面神经解剖保留至关重要。

Facial nerve preservation in acoustic neuroma microsurgery

Objective To study the skills of facial nerve preservation in acoustic neuroma microsurgery. Methods Seventy four cases of acoustic neuromas treated microsurgically by suboccipital retrosigmoid transmeatus approach were analyzed retrospectively, including their clinical symptoms and characteristic image, the pathological anatomic relationships of facial nerve and tumor, microsurgical technique. Results Total resection of the tumor was achieved microsurgically in 72 cases, subtotal resection in 2 cases. Facial nerve was kept anatomic intact in 67(90.5%) of the patients. Intracranial end to end anastomosis of the facial nerve was performed in 4 cases. No patient died in this series. Conclusions Microneurosurgical technique is a safe and effective method for total resection of acoustic neuroma. It is key point for keeping facial nerve anatomic intact to understand the pathological anatomic relationships of facial nerve and tumor.