术中脑干听觉诱发电位监测听神经瘤的听力保护

目的评价术中BAEP监测对提高听力保留率的价值。方法采用乙状窦后入路,在脑干听觉诱发电位(BAEP)监测下完成的听神经瘤切除术7例。将术前、术中、术后ABR结果,及术前、术后听力结果进行分析,并与没有应用BAEP术中监护的11例进行比较分析。结果甲组11例术后无有效听力。甲组手术前后电测听值变化具有统计学意义(P<0.05);乙组术后平均电测听值39.1 dB,均为有效听力,手术前后电测听值比较差异无统计学意义(P>0.05)。结论应用BEAP术中监测,对提高听力保护有积极意义,能及时反映术中与保留听力相关的敏感手术步骤。然而,外科医师的熟练的解剖和精确的手术技巧,也是手术成功的最基本因素。

Hearing Preservation by Intraoperative BAEP Monitoring Techniques in Acoustic Neuroma Microsurgery

Objective To investigate the value of intraoperative auditory monitoring techniques in acoustic neuromas microsurgery.Methods 11 cases with acoustic neuromas were resected by retrosigmoid approach.Continuous hearing monitoring of BAEP was performed during operation in group B,and we also analysed with the patients who without hearing monitoring of auditory brainstem responses during their surgery.Results With the skills improving in those operations,the hearing was preserved in group B.In group A,there are not any hearing because that they did not use hearing monitoring of BAEP.Conclusion With reflecting those sensitive steps of surgery revolving hearing preservation,BEAP monitoring was proved to be a useful supplementary tool for hearing preservation in acoustic neuromas surgery.The surgeon′s experiences are the most significant factors influencing the hearing outcome in removal of acoustic neuromas.