显微手术切除听神经瘤临床疗效分析（附94例报告）

发布时间：2018-12-29 17:22

【摘要】：目的：评价经枕下乙状窦后经内听道入路,术中神经电生理监测下显微手术切除听神经瘤的疗效。方法：本组回顾性分析了94例听神经瘤的病例,均采用枕下乙状窦后经内听道入路行显微手术切除,术中均行神经电生理监测。结果：本组肿瘤全切除93例(98.9%)；次全切除1例(1.1%)；面神经解剖保留94例(100%)；岩静脉解剖保留91例(96.8%)；听力保留14例/71例(19.7%)；无死亡病例。结论：1.显微外科手术是治疗听神经瘤的一种安全有效的方法。 2.通过采取枕下乙状窦后经内听道入路,术中配合良好的神经电生理监测技术及熟练的显微外科操作技巧,有助于提高听神经瘤的全切率、面听神经功能保留率及岩静脉的保留率,术后注意并发症的防治,从而使绝大多数听神经瘤患者获得满意的临床疗效。 3.肿瘤的大小是影响术后面神经功能的重要因素。 4.对于技术成熟的术者,小型听神经瘤仍首选显微手术治疗。
[Abstract]:Objective: to evaluate the effect of microsurgical resection of acoustic neuroma by transoccipital retrosigmoid sinus approach and intraoperative neurophysiological monitoring. Methods: 94 cases of acoustic neuroma were retrospectively analyzed. All the patients underwent microsurgical resection through the internal auditory canal through the suboccipital sigmoid sinus. The electrophysiological monitoring was performed during the operation. Results: there were 93 cases (98.9%) of total tumor resection, 1 case (1.1%) of subtotal resection, 94 cases (100%) of anatomic preservation of facial nerve, 91 cases (96.8%) of anatomic preservation of petrosal vein. There were 14 cases (19.7%) with hearing retention and no death. Conclusion: 1. Microsurgery is a safe and effective method for the treatment of acoustic neuroma. 2. By adopting the retrosigmoid sinus approach through the internal auditory canal, good neuroelectrophysiological monitoring technique and skillful microsurgical techniques, the total removal rate of acoustic neuroma can be improved. The preservation rate of facial acoustic nerve function and the preservation rate of petrosal vein and the prevention and treatment of postoperative complications made the majority of patients with acoustic neuroma obtain satisfactory clinical effect. 3. Tumor size is an important factor affecting facial nerve function after operation. 4. Microsurgery is still the preferred treatment for small acoustic neuroma for mature surgical operators.
【学位授予单位】：中南大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R739.4

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