听神经瘤显微手术保留听神经功能及影响因素分析

目的　探讨听神经瘤显微手术保留听神经功能及其影响因素。方法　收集我院近 2年来 2 3例经枕下乙状窦后入路显微手术的初发听神经瘤资料 ,其中包括肿瘤大小、术前术后听力、肿瘤内听道底侵蚀及术后小脑损伤情况。结果　耳蜗神经解剖保留 1 9例 ,保留有效听力 2例 (占术前存在有效听力患者的 33 3 % ) ,有效听力丧失保留可测听力 1 0例。听力的保留与肿瘤大小、术前听力水平、肿瘤内听道底侵蚀、小脑损伤相关。结论　肿瘤的大小、术前听力水平、肿瘤内听道底侵蚀和小脑损伤是听神经瘤术后听神经功能保留的影响因素。

Hearing preservation and influence factors in microsurgery of acoustic neuroma

Objective To discuss hearing preservation and influence factors in microsurgery of acoustic neuroma. Methods We collected the data of 23 patients with acoustic neuroma microsurgery undergoing retrosigmoid approach in our hospital during 1999 2002 including tumor size, preoperative and postoperative hearing level,internal auditory canal fundus destroying, postoperative cerebellum damaging. Results 19 patients preserved cochlear nerve intactly, 2 patients had effective hearing(accout for 33 3% patients coith effective hearing preoperatively), 10 patients had preserve measureable but not effective hearing. Hearing preservation was correlation to tumor size, preoperative hearing level, internal auditory canal fundus destroying and cerebellum damaging. Conclusions Tumor size, preoperative hearing level, internal auditory canal fundus destroying and cerebellum damaging were the influence factors of hearing preservation in acoustic neuroma microsurgery.