大型听神经瘤显微手术治疗

目的探讨大型听神经瘤的显微手术经验。 方法回顾性分析解放军九六〇医院神经外科自2002年1月至2015年12月收治的47例大型听神经瘤患者，均行枕下乙状窦后入路显微外科切除术，采用术后House-Brackman面神经功能分级评价面神经功能并观察术后并发症。 结果肿瘤全切除者47例，面神经解剖保留者45例。术后House-Brackman面神经功能分级Ⅰ~Ⅱ级27例，Ⅲ~Ⅳ级17例，V级3例。术后38例患者恢复良好，8例出现术后不良反应，1例死亡。 结论采用显微外科手术技术可以切除大型听神经瘤并获得面神经解剖的保护，临床疗效良好。

Microsurgery for large vestibular schwannomas

ObjectiveTo explore the microsurgical experience of large vestibular schwannomas. MethodsA retrospective analysis was made of 47 cases of large vestibular schwannomas treated in Department of Neurosurgery, 960 Hospital of PLA from January 2002 to December 2015. All of them underwent microsurgical resection via retrosigmoid suboccipital approach. Facial nerve function was evaluated by House-Brackman functional grading after operation and complications were observed. ResultsTotal resection of tumors was performed in 47 cases and facial nerve was preserved in 45 cases. After operation, House-Brackman facial nerve functional grade Ⅰ-Ⅱ in 27 cases, Ⅲ-Ⅳ in 17 cases and V in 3 cases. After operation, 38 patients recovered well, 8 patients had adverse reactions and 1 patient died. ConclusionUsing microsurgical technique, large vestibular schwannomas can be removed and facial nerve anatomy can be protected, and the clinical effect is good.