听神经瘤显微外科手术中的听觉功能保护

目的:探讨显微外科手术治疗听神经瘤听觉功能的保护以及影响术后听力的因素。方法:对53例听神经瘤患者施行枕后乙状窦后入路显微外科手术,比较术前术后患者的听力。结果:本组病例肿瘤手术全切48例(90.6%),次全切除5例(9.4%),听神经解剖保留47例(88.7%)。术后2周保留有效听力10例(71.4%),有效听力丧失但保留可测听力27例,听力完全丧失16例。2 cm肿瘤术后保留有效听力5例(45.5%),2 cm肿瘤术后保留有效听力6例(14.3%)。结论:肿瘤的大小与听力保留有相关性,手术入路的选择、手术操作的经验和技巧是成功切除肿瘤和保存神经功能的关键。

Hearing Preservation in Microsurgery of Acoustic Neuromas

Objective:To investigate the effect of microsurgery of acoustic neuromas on hearing.Methods:Fifty-three patients with acoustic neuromas underwent microsurgery through retrosigmoid approach.Hearing function before and after surgery was tested and compared.Results:Tumors were totally resected in 48 cases(90.6%),subtotally resected in 5 cases(9.4%).Cochlear nerves were anatomically preservered in 47 cases(88.7%).Effective hearing was kept in 10 patients after surgery(71.4%) and measurable hearing was kept in 27 patients,while 16 patients showed total hearing loss.Effective hearing was kept in 5 cases(45.5%) in small tumor group(<2 cm) and 6 cases(14.3%) in large tumor group(>2 cm).Conclusion:Hearing preservation is related to tumor sizes.Surgery approach selection and operation skills are the key factors in successful resection of tumors and preservation of the nerve function.