大型听神经瘤的显微手术入路探讨

目的 探讨切除大型听神经瘤的手术入路、操作技巧及治疗效果。方法对55例大型听神经瘤患者采用显微手术治疗，其中经枕下-乙状窦后入路手术治疗45例，经岩骨乙状窦前入路手术治疗10例。结果肿瘤全切49例，次全切除6例。面神经解剖保留率为85．45％（47155）。术后随访1年，面神经解剖保留者中有35例面神经功能获得满意恢复。经岩骨乙状窦前入路并发症多见。结论经枕下-乙状窦后入路显微手术切除大型听神经瘤，可获得满意的面神经解剖学保留与功能保护，能明显降低并发症的发生率。

Microsurgical Management of Large Acoustic Neuromas

Objective To explore the microsurgical technique through a suboccipital retrosigmoid approach, and prognosis in the patients with large acoustic neurotnas. Methods The clinical data of 55 patients with large acoustic neuromas, of whom, 45 were treated by microsurgery through suboccipital retrosigmoid approach and 10 were treated by microsurgery through presigmoid approach, were analysed retrospectively. Results Of 55 patients with large acoustic neuromas, 49 received total resection of the tumors and 6 subtotal. The facial nerves were preserved anatomically in 47 patients （85.45%, 47/55）. The following up one year after the operation showed that the facial nerve functions were recovered well in 35（63.6%, 35/55） of 47 patients whose facial nerves were preserved anatomically. Conclusion The microsurgery through suboccipital retrosigmoid approach for the large acoustic neuromas can result in good anatomical and functional preservation of the facial nerve, and decrease the operative complications.