大型听神经瘤的显微手术切除的疗效

目的 探讨经枕下乙状窦后入路显微手术技术对大型听神经瘤切除的临床疗效和意义。方法 采用枕下乙状窦后入路对94例大型听神经瘤患者应用显微手术切除术。分别在术前及术后进行听神经和面神经功能评估，总结临床疗效和经验。结果 手术完全切除肿瘤者84例(89．3％)，次全切除10例(10．6％)。听神经解剖保留10例(10．6％)，功能保留2例(2．2％)；面神经解剖保留68例(72．3％)，功能保留42例(44．6％)。术后死亡2例(2．2％)。结论 经枕下乙状窦后入路显微手术切除大型听神经瘤是一种安全、有效的方法，对大型听神经瘤的手术切除必须在手术显微镜下进行，显微手术技术可提高大型听神经瘤全切率，有效保护肿瘤周围的重要神经结构，减少术后并发症和死亡率。

Microsurgical technique in treatment of patients with large acoustic neurinoma

Objective To investigate the clinical efficacy and significance of trans suboccipital postsigmoid sinus microsurgical approach in treatment of patients with large acoustic neurinoma. Methods Ninety four patients with large acoustic neurinoma underwent trans suboccipital postsigmoid sinus microsurgical approach. Functions of acoustic nerve and facial nerve were assessed before and after operation. The clinical efficacy and experiences were summarized. Results The large acoustic neurinoma was completely resected in 84 cases (89 3%) and mostly resected in 10 cases (10 6%). The acoustic nerve was preserved anatomically in 10 cases (10 6%) and functionally in 2 cases (2 2%). The facial nerve was preserved anatomically in 68 cases (72 3%) and functionally in 42 cases (44 6%). Death occurred in 2 cases after operation (2 2%). Conclusion Trans suboccipital postsigmoid sinus approach is a safe and effective microsurgical technique in treatment of patients with large acoustic neurinoma. This technique can increase the total removal rate of the tumor, protect important structures around the tumor effectively and reduce the postoperative complications and the death rate.