大型听神经瘤显微手术治疗和面神经保留

目的:总结65例听神经瘤采用显微外科技术的体会。方法:应用枕下乙状窦后入路采用显微外科技术切除肿瘤。结果:肿瘤全切除59例(91％),次全切除6例(9％)。面神经解剖保留54例(83％),功能保留46例(71％),面神经功能根据House-Brackmann,Ⅰ～Ⅱ级38例(58％),Ⅲ～Ⅳ级19例(29％),Ⅴ～Ⅵ级8例(13％)。结论:熟悉小脑桥脑角及周围区域的正常和病理解剖,采用显微外科技术,大多数大型听神经瘤均可保留面神经解剖完整的前提下手术全切。

Microsurgical treatment of large acoustic neurinomas and preservation of facial never

objective To summarize our experience of microsurgical treatment in 65 cases with acoustic neurinornas. Method The suboccipital retrosigrnoid approach were used by microsurgical technique. Result the tumors were totally removed in 59(91% )cases ,subtoytally removed in 6(9% )cases. 54(83% ) cases facial nevers were anatomically preserved and functional reservation in 46(71% ) cases. According to House - Brackmann facial nerve grading system : 38(58% ) of them were grade Ⅰ or Ⅱ,19(29%) were Ⅲ or Ⅲ, and 8(13% ) were Ⅳ or Ⅵ. Conclusion It is important to be familiar to the mi -croanatomy of the cerebellopontine angle, and by using microsurgical skill, almost all of the large acoustic neurinomas could be totally resected -with an anatomically facial nerve.