显微手术切除大型听神经瘤31例报告

目的:探讨大型听神经瘤的诊断、经枕下乙状窦后入路显微手术切除的操作技术及预后。方法:采用CT及MRI扫描检查和显微外科技术,对31例大型听神经瘤行手术切除,术中及术后评估面神经的功能。结果:本组26例(83.9%)肿瘤达到全切除,5例(16.1%)次全切除。面神经的解剖学保留率为77.2%(24例)。对26例进行1年以上的随访评估,面神经功能获得满意恢复者为22例(70.9%)。结论:采用经枕下乙状窦后入路,显微手术切除大型听神经瘤,对面神经可获得解剖学与功能的保护,能明显降低并发症与病死率。

Microsurgical management of large acoustic neuromas

Objective: To evaluate the diagnosis of the large acoustic neuromas , microsurgical resection via a suboccipital retrosigmoid approach ,and prognosis . Methods:Using the CT or MRI scanning and microsurgical techniques, we conducted surgeries for 31 cases of patients with large acoustic neuromas . The intraoperative and postoperative facial nerve function was evaluated . Results: Total tumor removal was achieved in 26 cases (83.9%) and subtotal tumor removal in 5 cases (16.1%) . The facial nerve was preserved anatomically in 24 cases (77.2%) of the patients . Facial nerve function were obtained in 22 cases (70.9%) by the time of follow-up assessment one year later . Conclusion: Use of the microsurgical techniques for removing large acoustic neuromas resulted in good anatomical and functional preservation of the facial nerve , with minimum incidence of morbidity and low mortality .