听神经瘤术中电生理监测提高面神经保留率的临床研究

目的探讨听神经瘤显微外科手术中采用电生理监测对提高面神经保留率的应用价值。方法对244例采用乙状窦后入路切除的听神经瘤患者进行回顾性研究,其中电生理监测组132例,对照组112例未行术中监测。对比分析两组面神经解剖保留率和术后2 w内的面神经功能保留率。结果电生理监测组面神经解剖保留率为90.9%,Ⅲ级及以下面神经功能保留率为84.8%;对照组解剖保留率为81.3%,Ⅲ级及以下功能保留率为65.2%,两组间数据具有统计学差异。结论采用术中面神经电生理监测可以显著提高面神经解剖保留率和功能保留率。

Facial nerve electromyography monitoring increases preservation rate of acoustic neuromas： a clinical study

Objective The validity of intraoperative electromyography（ EMG） monitoring for protecting facial nerve function and preserving nerve integrity in acoustic neuroma microsurgery is discussed. Methods A total of 244 patients who underwent acoustic neuroma microsurgery from January 2000 to June 2010 were studied retrospectively. All of them were operated via suboccipital retrosigmoid approach. Intra-operative EMG monitoring was used in 132 cases of observation group,while 112 cases in the control group were performed surgery without EMG monitoring. The anatomic integrity of the facial nerve and the facial nerve function 2 w after surgery were compared and analyzed. Results The anatomic integrity of the facial nerve was preserved in120 cases（90. 9%） in the observation group with intra-operative EMG monitoring and the facial nerve function was excellent / good / fair（ HB I-III） in 112 cases（84. 8%）. While in the control group,the anatomic integrity of the facial nerve was preserved in 91 cases（81. 3%） and the facial nerve function was excellent /good / fair（ HB I-III） in 73 cases（65. 2%）. The difference of anatomic integrity and the facial nerve function between two groups was significant（ P 0. 05）. Conclusion The results indicate that intraoperative EMG monitoring in acoustic neuroma operations is more effective which can increase the function and anatomic integrity of the facial nerve.