全程面神经监测在听神经瘤术中面神经保护的应用研究

发布时间：2018-04-16 21:08

  本文选题：神经瘤 + 听　； 参考：《中国全科医学》2017年29期

【摘要】：目的研究全程面神经监测即术前应用磁共振弥散张量成像(DTI)技术行面神经成像、术中联合面神经电生理监测技术,探讨其在听神经瘤术中面神经保护的意义。方法选取2016年1月—2017年1月南昌大学附属赣州医院收治的听神经瘤患者11例,术前采用面神经DTI显示肿瘤与面神经的关系,术中行面神经动态、电刺激肌电图,并检验DTI对面神经的定位准确与否,术后评估面神经功能。结果 11例听神经瘤面神经可通过DTI技术显示,面神经均位于肿瘤腹侧,7例位于肿瘤中部1/3,2例位于肿瘤下部1/3,2例位于肿瘤上部1/3,术前定位结果与术中所见吻合率为100%。10例肿瘤全部切除,1例内听道部分肿瘤残余。术中面神经动态肌电图监测可提示及定位面神经,11例面神经均解剖保留,保留率为100%。术后随访1~12个月,面神经功能House-BrackmannⅠ级4例,Ⅱ级6例,Ⅲ级1例。结论通过术前面神经DTI和术中神经电生理监测的全程监测技术,有助于术中定位和保护面神经,可提高听神经瘤术中面神经的解剖及功能保留率。
[Abstract]:Objective to study the application of magnetic resonance diffusion Zhang Liang imaging (DTI) technique in facial nerve monitoring, and to explore the significance of facial nerve protection in acoustic neuroma.Methods Eleven patients with acoustic neuroma treated in Ganzhou Hospital affiliated to Nanchang University from January 2016 to January 2017 were selected. Facial nerve DTI was used to show the relationship between the tumor and the facial nerve before operation. The facial nerve dynamic and electromyography were performed during the operation.The localization of facial nerve by DTI was tested and the function of facial nerve was evaluated after operation.Results the facial nerve of 11 cases of acoustic neuroma could be displayed by DTI technique.The facial nerves were located in the ventral side of the tumor in 7 cases, in the middle of the tumor 1 / 3 in 2 cases, in the lower part of the tumor 1 / 3 in 2 cases, in the upper part of the tumor 1 / 3. The anastomosis rate between the preoperative localization and the intraoperative findings was 100%. 10 cases of the tumor were completely resected and 1 case had partial tumor remnant in the internal auditory tract.The dynamic electromyography monitoring of facial nerve during operation can indicate and locate the facial nerve in 11 cases with anatomic preservation, and the retention rate is 100%.The patients were followed up for 1 ~ 12 months. There were 4 cases of House-Brackmann grade 鈪，

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