显微外科手术治疗大型听神经瘤

目的：探讨大型听神经瘤的显微外科治疗及面神经保护。方法：对27例大型听神经瘤（直径〉3cm）均采用枕下乙状窦后入路，手术均在面神经电生理监测下进行，显微外科切除肿瘤，肿瘤切除后对面神经功能进行评价。结果：肿瘤全切除27例（100％），无手术死亡；面神经保留25例，占92．6％。面神经功能状态H—B分级，Ⅰ～Ⅱ级21例，Ⅲ～Ⅳ级5例，Ⅴ级1例。结论：显微外科手术结合术中电生理监测，有利于提高大型听神经瘤的全切率，手术面神经的保留率。

THE MICROSURGICAL TREATMENT OF LARGE ACOUSTIC NEURORMAS

Objective：To investigate the microsurgery treatment of large acoustic neurormas and the preservation of facial nerves. Methods： 27 patients with large acoustic neurormas were operated via suboccipital retrosigmold approaeh,intraoperative EMG monitoring was used to protect facial nerve,and its function evaluated.FiesuitS：Total removal was achieved in 27 patients （100%）. The facial nerve preserved and evaluated anatomieally in 25 cases （92.6%）,（H-B Grade Ⅰ -Ⅱ in 21）,（Grade Ⅲ-Ⅳin 5）,（Grade Vin 1）.No patient had long coma or died. Conclusion： The usage of microsurgery technology and the intraoperative monitoring were cornerstone to achieve the goal of total resection of large acoustic neuromas and the anatomic reservation of facial nerve.