小骨窗显微手术切除大型桥小脑角肿瘤及神经功能保护

目的探讨大型（直径≥3cm）桥小脑角肿瘤的小骨窗显微手术切除方法及神经功能保护。方法回顾性分析经乙状窦后入路小骨窗显微手术切除的32例大型桥小脑角肿瘤患者的临床资料，肿瘤全切除28例（87．5％），次全切除4例（12．5％）。结果本组无手术死亡病例。面神经解剖保留率为93．8％（30／32），面神经功能（House—BrackmannI、Ⅱ级）保留率为78．1％（25／32），听神经解剖保留率为87．5％（28／32），听力保留率68．8％（22／32）。结论采用乙状窦后入路小骨窗显微手术切除大型桥小脑角肿瘤是一种安全、有效的手术方法，在保留神经功能完整性的前提下应尽量切除肿瘤。

Keyhole surgery for large cerebellopontine angle tumors and intraoperative preservation of neural function

Objective To discuss the keyhole surgery for large cerebellopontine angle tumors and intraoperative preservation of neural function. Methods Thirty - two cases of large cerebellopontine angle tumors, which underwent microsurgery via suboccipital retrosigmoida keyhole approach from Mar. 2005 to Mar. 2010 were retrospectively reviewed and analyzed. Total resection was achieved in 28 cases（ 87.5% ）, subtotal resection in 4 cases （ 12.5% ）. Results The rate of anatomical preservation of facial nerve was 93.8% （30/32） ,and rate of its function preservation （House - Brackmann I , II ）was 78.1% （25/32）. The rate of anatomical preservation of auditory nerve was 87.5% （28/32）, and rate of its function preservation was 68.8% （22/32）. Conclusion The keyhole surgery is an effective and safe method to treat large cerebellopontine angle tumors. The primary principles in dealing with this disease include preservation of nerve function and total resection of the tumor as possible.