显微外科手术切除大型听神经瘤及保护面神经的技巧

目的:探讨大型听神经瘤显微镜下手术中的面神经保护技巧。方法:回顾性分析44例大型听神经瘤纤维手术切除患者的临床资料,总结归纳手术操作技巧。结果:本组44例患者中肿瘤全切除36例(81.82%),次全切除6例(13.64%),部分切除4例(9.09%);术中面神经完整保留38例(86.36%),术后随访1年,患者无复发迹象,面瘫恢复不良5例。结论:听神经瘤体积越大,手术中保留面神经的难度越大。大型听神经瘤的显微下切除需要手术医师具有熟悉的显微手术技巧、对手术相当的耐心和信心。

Application of microsurgery in incising large acoustic neuroma and skills of protecting nervus facialis

Objective:To explore the skills of protecting nervus facialis during incision of large acoustic neuroma by microsurgery.Methods:The clinical data of 44 patients with microsurgery for large acoustic neuroma were analyzed retrospectively,so as to summarize the surgical operation skills.Results:Of the 44 patients,36 (81.82％) received total resection,6 (13.64％) received subtotal resection and 4 (9.09％) received partial resection.During operation,38 (86.36％) patients had nervus facialis preserved completely.All patients were followed up by one year,and none had recurrence,but 5 patients had poor reeovery of facial paralysis.Conclusion:The large the size of acoustic neuroma is,the more difficulty of intra-operative preservation of nervus facialis will become.The microsurgery of large acoustic neuroma requires that surgeons should be familiar to the microsurgery skills,and have enough patience and confidence to the surgery.