126例听神经瘤个体化治疗体会

目的总结连续治疗126例听神经瘤的体会,探讨选择性采用手术或γ-刀治疗听神经瘤的效果。方法对选择性采用手术或γ-刀治疗的126例听神经瘤病例（127个肿瘤,包括1例双侧听神经瘤）进行回顾性分析。结果枕下乙状窦后入路显微手术切除104例,行γ-刀治疗23例（1例双侧听神经瘤行以上两种治疗）。手术全切88例（84.6%）,大部切除14例（13.5%）,术后死亡2例（1.9%）。术后面神经功能保留64例（61.5%）,随访后面神经功能保留73例（70.2%）。γ-刀治疗面神经功能保留7例（30.4%）。结论听神经瘤的治疗应根据症状、体征、肿瘤大小、肿瘤生长情况及患者全身状况,个体化的选择治疗方式。选择性采用手术或γ-刀治疗听神经瘤是一种有效,可行的治疗模式。

Individualized management of 126 cases of acoustic neuromas

Objective To summarize the surgical management of 126 cases of acoustic neuromas and to investigate the effect of surgery or γ-knife on selected cases.Methods A total of 126 cases （127 acoustic neuromas,including 1 case with bilateral acoustic neuromas） with acoustic neuromas treated by surgery or γ-knife were analyzed retrospectively.Results Among all the cases,104 cases were performed microsurgery by suboccipital retrosigmoid approach and 23 cases were treated with γ-knife （1 case with bilateral acoustic neuromas was treated by the two methods）.Total resection was achieved in 88 cases （84.6%） and subtotal in 14 cases （13.5%）,and there were 2 dead cases （1.9%）.Preservation of facial nerve was achieved in 64 cases （61.5%） postoperation and 73 cases （70.2%） during follow-up.The functional preservation of facial nerve by γ-knife was achieved in 7 cases （30.4%）.Conclusion Individualized therapy should be formulated on the basis of symptoms,signs,tumor growth,and general condition for the patients with acoustic neuromas.Selective use of surgery or γ-knife is an effective and feasible modality for acoustic neuromas.