枕下乙状窦后入路显微手术切除听神经瘤

目的总结枕下乙状窦后入路切除听神经瘤的临床经验。方法采用单侧枕下乙状窦后入路,运用显微外科技术切除听神经瘤71例,其中17例采用内窥镜辅助小骨窗(3.0cm×3.5cm)手术。结果肿瘤镜下全切除63例(88.7%),次全切除8例(11.3%)。面神经解剖保留54例(76.1%),功能保留37例(52.1%),有效听力保留2例(2.8%),无手术死亡。结论经枕下乙状窦后入路显微手术治疗听神经瘤,能获得对听神经瘤及桥小脑角的良好显露,手术效果满意。

Suboccipito-retrosigmoidal Approach for Microsurgical Resection of Acoustic Neuroma

Objective To summarize the clinical experience of acoustic neuroma resection via suboccipito-retrosigmoidal approach. Methods 71 cases of acoustic neuroma were microsurgically resected via unilateral suboccipito-retrosigmoidal approach. Among them 17 cases underwent neuroendoscope-assisted resection via a small craniotomy. Results The tumors were completely removed in 63 cases (88.7%) and subtotally removed in 8 cases (11.3%). Facial nerve was preserved anatomically in 54 cases(76.1%) and functionally in 37 cases(52.1%). Anditognosis was preserved in 2 cases (2.8%). No intraoperative death occurred. Conclusion Adequate exposure of acoustic neuroma and cerebellopontine angle (CPA) could be achieved via this approach, greatly guaranteeing good surgical outcome.