听神经瘤手术治疗的临床体会

目的 总结104例听神经瘤手术切除的体会，以提高此类手术的治疗效果。方法 经CT或MRI扫描检查确诊，应用显微外科技术，经枕下-乙状窦后入路行肿瘤切除术。结果 肿瘤全切89例（85．58％），次全切和大部切除15例（14．42％）；术后死亡2例（1．92％）。术中面神经解剖保留89例（85．58％），听神经解剖保留25例（24．04％），术后7例（6．73％）听力保存或有所改善。结论 肿瘤大小与肿瘤全切率及面、听神经保留率密切相关。合适的体位，正确的切除方法及较强的功能保护观念，是提高听神经瘤手术疗效的关键。

Surgical Management of Acoustic Neuromas

Objective To summarize the experience in surgically resecting 104 cases of acoustic neuromas in order to improve the therapeutic effects of surgery on acoustic neuromas. Methods The acoustic neuromas were definitely diagnosed by CT or MRI scanning in 104 patients. All the tumors were removed by microsurgery through suboccipital retrosigmoid approach. Results Of 104 patients with acoustic neuromas, 89 received total resection of the tumors and 15 subtotal or greatly partial. Two patients died after the surgery. The anatomic preservation of facial nerve and acoustic nerve was achieved respectively in 89 cases (85.58%) and 25 cases (24.04%). The hearing in 7 patients(6.73%) was preserved or improved. Conclusions The size of the acoustic neuromas was closely related to the rate of total removal of the tumors and the preservative rates of facial nerve and acoustic nerve. The key to improving the surgical effects on acoustic neuromas are skillful microsurgical technique and idea of preservation of nervous function.