内窥镜下桥小脑角手术  

Endoscopic surgery of fhe cerebellopontine angle

作　　者：王锡温[1] 李树峰[1] 陈秀梅[1] 张庆泉[1] 姚玉健[1] 邢建萍[1] 

机构地区：[1]山东烟台毓璜顶医院耳鼻咽喉科,烟台264000

出　　处：《中华耳科学杂志》2003年第1期29-31,共3页Chinese Journal of Otology

摘　　要：目的 探讨内窥镜在桥小脑角手术中的适应症、技术方法。方法 气管插管全身麻醉,通过录像监视器观察,内窥镜经乙状窦后进路进入桥小脑角,首先看到面、听神经和内听道,内窥镜向上可看到三叉神经、外展神经、岩静脉,向下可看到颈静脉孔和舌咽、迷走神经、然后根据下同的手术要求进行神经根减压、梳理及选择性切断术。结果 面神经根梳理术3例;三叉神经根减压术1例;感觉根选择性切断术9例;前庭神经切断术3例。结论 内窥镜扩大了桥小脑角区的手术视野,可以观察到手术显微镜下不易观察到的部位,减少了手术创伤,增加了手术的安全性。Objective To dicuss the surgical indication, the techniques and methods of endoscopic surgery of the cerebel-lopontine anfle. Methods All patients wereoperated under general anesthesia and intubation. The endoscope was intro-ducedynto the cerebellopontine angle aftw the retrosigmoid approach, At first, the acousticofacial nerve and the internal auditory canal were examined then, the trigeminal and abducent never as well as petrosal vein can be seen by moving the endoscope superiorly from the internal auditory canal. The jugular foraman, the glossopharyngeal and vagus nerve can be viewed by the endoscope moving inferiorly from the internal auditory canal. According to the purpose of the diffetent operation, the surgeon can choose microvascular decompression, neurectomy or nerve splitting. Result The endoscopic surgery were performed in all 16 patinets, including 3 cases of facial nerve splitteng, 9 cases of selective trigeminal neurectomy 9 cases, 1 case of trigeminal nerve decompression 3 cases of vestibular nuerectomy. Conclusion Endoscopy may enlarge operative field of vision, cause less operative trarma. The operative safety could be greatly improved.

关 键 词：桥小脑角 内窥镜 临床应用 

分 类 号：R76[医药卫生—耳鼻咽喉科]