显微手术切除巨大听神经瘤的策略、技巧及相关并发症的处理

目的：探讨显微手术切除巨大听神经瘤的策略和技巧。方法：总结327例巨大听神经瘤的临床表现、显微手术方法、手术结果和术后处理。结果：本组全切293例（89．6％），次全切34例（10．4％）。术中解剖保留面神经312例（95．4％），功能保留187例（57．1％）。无死亡病例。12例有一过性后组颅神经麻痹，出院时症状基本消失，1例出现永久性面瘫。结论：根据术前和术中的策略，选择好手术入路和运用好显微外科技术可以提高巨大听神经瘤的切除率、面神经功能保护率及减少手术并发症。

Microsuraical Strategy and Technique for Large Acoustic Neurilemomaand Treatment of Relevant the Complication

Objective:To discuss the strategy and technique of large acoustic neurilemoma removed by microsurgery.Methods:To analyze the clinical performances,ways results of operations managenent after operations in 327 patients.Results:Total acoustic neuroma removed was in 293 patients(89.6%),and 34 patients(10.4%)had subtotal removed.On the other hand,cochlear nerve anatomic was preserved in 312 patients following careful dissection(95.4%),and the facial nerve function was preserved in 187 patients(57.1%),with no mortality.However,12 patients had short-term paralysis of the cranial nerve,symptoms had almost disappeared before patients left hospital,but only one had persistent facial paralysis.Conclusions:On the basis of strategies before and during the operation,correct surgical approach and microsurgery technique could improve the rate of resection and rate of keeping facial nerve intact and reduce the complications from operations.