枕下乙状窦后锁孔入路显微手术切除大型听神经瘤

目的总结枕下乙状窦后锁孔人路切除听神经瘤的临床经验.方法对42例大型听神经瘤行乙状窦后锁孔入路,在耳后发际内1 cm作6 cm小弧形切口,骨窗2.5～3.0 cm,显微手术切除肿瘤.结果肿瘤全切除40例(95.2%),近全切除2例;面神经解剖保留37例(88%),功能保留30例(71.4%);耳蜗神经解剖保留3例,有效听力保留1例;无手术死亡.结论经乙状窦后锁孔入路同样能获得对听神经瘤及桥小脑角神经、血管的良好显露.

Suboccipito-retrosigmoidal keyhole approach for resection of large acoustic neuroma

Objective To summarize the clinical experience of resection acoustic neuroma via suboccipito-retrosigmoidal keyhole approach. Methods 42 patients with large acoustic neuroma were operated via suboccipito-retrosigmoidal keyhole approach, a small arc incision of 6cm was made in retroauricular region and 1cm internal to hairline, the diameter of bone window was 2.5-3.0cm. Results Total resection was achieved in 40 cases (95.2%), and subtotal in 2 cases. Anatomic reservation rate of facial nerve was 88% (37 cases), and functional reservation rate was 71.4% (30 cases), cochlear nerve was reserved in 3 cases, and effective audition was reserved in 1 patient. No patient died. Conclusions Good exposure of acoustic neuroma, the nerves and vessels in CPA could be acquired via suboccipito-retrosigmoidal keyhole approach.