儿童听神经瘤

目的 探讨儿童听神经瘤的临床特征及疗效.方法 回顾性分析1994年1月至2007年12月手术治疗的10例儿童听神经瘤.结果 男6例,女4例,年龄11-15岁,平均为13.9岁.所有患儿均行头颅CT和(或)MRI检查,颅内压增高、失聪及共济障碍为其主要临床表现.肿瘤最大径为3～7 cm(平均5.15 cm),均采用枕下乙状窦后入路手术.肿瘤全切除9例,部分切除1例,手术死亡1例,8例随访1-12年,面神经功能Ⅳ～Ⅴ级2例,Ⅱ～Ⅲ级5例,Ⅰ级1例;听力保留1例.结论 儿童听神经瘤十分少见,临床表现不如成人典型,部分听神经瘤血供极为丰富,术中出血汹涌,保留面、听神经较为困难.

Acoustic neurinoma in children

Objective To investigate the clinical presentation and management issues of acoustic neuroma in children. Methods A retrospective review of ten children with acoustic neurinoma treated between January 1994 and December 2007 was performed. Results There were 6 boys and 4 girls with a median age of 13.9 years olds in this group. CT or/and MRI were performed in all children. The common clinical features were increased ICP, hearing loss and ataxia.The median diameter of the tumors was 5.15 cm varied from 3 cm to 7 cm.Complete resection was achieved in 9 out of 10 patients(partial resection in 1 patient)via suboccipital retrosigmoid approach and perioperitive mortality rate was 10%.The follow-up period of patients ranged from 1 year to 12 years.Postoperatively the facial nerve of one patient recovered to grade Ⅰ, five to grade Ⅱ～Ⅲ and two to Ⅳ～Ⅴ of House-Brackmann classification. Preservation of hearing function was achieved in only one patient. Conclusions Acoustic neurinoma is rare in children.The clinical features of pediatric acoustic neurinoma is different from those of adult.The cranial nerve preservation in children is more difficult.