听神经瘤显微手术后听力保存及影响因素  

Hearing preservation after vestibular schwannoma microsurgery

作　　者：蔡德泉[1] 华清泉[1] 

机构地区：[1]武汉大学人民医院耳鼻咽喉-头颈外科,武汉430060

出　　处：《中国听力语言康复科学杂志》2009年第4期18-22,共5页Chinese Scientific Journal of Hearing and Speech Rehabilitation

摘　　要：目的探讨听神经瘤显微手术后听力保存结果并分析其影响因素。方法回顾性研究1998年1月～2008年1月显微外科手术治疗听神经瘤32例，影像学检查（MRI）确定肿瘤大小及生长部位，听力学检查确定术前、术后听力水平，分析术前听力情况、肿瘤的大小及生长部位与术后听力保存之间的关系。结果32例听神经瘤均实现肿瘤完全切除。术后实用听力保存率为15．6％（5／32）。术前听力水平A级6例，B级8例，术后听力保存率分别为50％（3／6）和25％（2／8）。内听道型肿瘤（IAC）9例，直径1-19mm小肿瘤4例。听力保存率分别为44．4％4／9）；和25％（1／4）。20例哑铃型肿瘤，1例术后保存了实用听力。在IAC型肿瘤中，3例中心型肿瘤术后均实现了听力保存，近内耳门型肿瘤2例，1例术后具有实用听力。结论术前听力情况、肿瘤大小及生长部位是预测术后听力的重要因素。Objective To evaluate the hearing preservation results after the vestibular schwannoma microsurgery and related factors. Methods The data of thirty-two patients who underwent the microsurgical resection of vestibular schwannomas were retrospectively reviewed. The relationships between tumor sizes and Iocalizations, preoperative hearing levels and postoperative hearing preservation were analyzed. Results The tumors of all cases were removed completely and 15.6% of the subjects （5/32） maintained residual hearing. For those with hearing level A and B, 50%（3/6）and 25%（2/8）had residual hearing, and for those with IAC tumors and small tumors of 1-19 mm, 44.4%（4/9）and 25%（1/4）maintained residual hearing. The functional hearing was preserved in 1 out of 20 patients with intermediate tumors, and in 3 patients with central tumors and 1 with porus-near tumor. Conclusion This study shows that the preoperative hearing levels, tumor sizes and Iocalizations are important indicators for hearing preservation after vestibular schwannoma microsurgery.

关 键 词：听神经瘤 听力保存 肿瘤大小 生长部位 术前听力水平 

分 类 号：R764.9[医药卫生—耳鼻咽喉科]