听神经瘤切除面神经保留技术的探讨

目的探讨和分析中、大型听神经瘤手术面神经保留技术。方法8例听神经瘤病人，采用枕下开颅乙状窦后经内听道入路。显微外科切除肿瘤。在面神经监护下，观察肿瘤与面神经的病理解剖关系，术后随访时间4个月至3年。结果肿瘤全切除7例，近全切1例，面神经解剖保留8例。结论术中首先识别不与肿瘤黏连的面神经脑干端及内听道端。再从两端沿面神经锐性分离肿瘤，是面神经解剖保留的技术关键。

Facial nerve reservation in aeousic neuromna surgery

Objective To summarize and analysis the skills of facial nerve rereservation in acoustic neuroma stugety. Methods 8 petients harboring acoustic neuroma in larger and medium size were treated surgically by suboccipital retrosigmoid intrameatus approach for reserving facial nerve. The pathological - anatomic relationships of tumor and facial turmor and facial nerve were studied, under nerve monitoring. Postoperative following up had continued from 4 months to 3 yeats. Results Total tumor resection was achieved in 6 of the 8patients, ncarlytotal in 1 and subtotal in1. Facial nerves were kept anatomic intact in 6 of the patients. Conclusions It is the key skill for keeping facial nerves anatomic intact to identify brainstem segment and intrameatus segmnent of facial nerves first, which is usually not stick on 1 tumor,and then separate the tumor along the nerve,