听神经瘤术中面神经保护及功能评估  

Facial nerve protection and its function evaluation during operation for acoustic tumor

作　　者：魏永[1] 梁日生[1] 杨卫忠[1] 林于峰[1] 宋施委[1] 房新蓉[1] 

机构地区：[1]福建医科大学附属协和医院神经外科,福建省福州市350001

出　　处：《国际神经病学神经外科学杂志》2009年第4期307-310,共4页Journal of International Neurology and Neurosurgery

摘　　要：目的探讨面神经肌电图监测在听神经瘤术中对面神经的保护和评估术后面神经功能的重要性。方法25例听神经瘤手术全程中行面神经肌电图监测,显微镜下切除肿瘤,术毕刺激面神经的脑干近端对预后进行评估。结果25例患者肿瘤全切除23例(92%),面神经解剖保留22例(88%),面神经功能良好保留21例(84%)。面神经解剖保留率与肿瘤的直径大小有相关性,肿瘤越大,面神经保留越难。刺激强度的大小与术后面神经功能存在明显的相关性,刺激强度越小,术后面神经功能越好。术末刺激强度在0.05～1.5mA之间,术后12个月面神经功能为Ⅰ、Ⅱ级者达19例(90.5%)。术末刺激强度大于7.0mA者,术后面神经功能恢复比较差。结论听神经瘤术中行面神经肌电图监测有助于提高面神经的解剖和功能保留率,并可评估术后面神经功能。Objective To explore the significance of facial nervous electromyogram monitoring in the protection of the facial nerve during operation for acoustic tumor and evaluation of its function after operation. Methods 25 patients with acoustic tumor were operated under the facial nervous electromyogram monitoring and the operating microscope. Stimulating the facial nerve near the brainstem to evaluate the prognosis at the end of the operation. Results Total removal was achieved in 23 patients（92% ）. The facial nerve was preserved anatomically in 22 patients（ 88% ）. The function of facial nerve was kept well in 21 cases（ 84% ）. Retention rate of facial nerve anatomy was related to tumor size in diameter, the tumor size was the larger, the retention of the facial nerve was more difficult. The stimulus intensity was related to the postoperative function of facial nerve. The stimulus intensity was the lower, the postoperative function of facial nerve was the better. When the stimulas intensity was between 0.05mA and 1.5mA at the end of operation, the function of facial nerve may be Ⅰ , Ⅱ grade. The functional grade of facial nerve was evaluated in 12 months after operation, grade Ⅰand grade Ⅱ was found in 19 cases（ 90.5% ） ; whereas, the functional grade was worse when the the stimulas intensity was over 7.0mA. Conclusions Intraoperative facial nervous electromyogram monitoring can increase the anatomical and function preservation rate of facial nerve and also can evaluate its function after operation.

关 键 词：面神经肌电图监测 听神经瘤 面神经保护 功能评估 

分 类 号：R739.4[医药卫生—肿瘤] R743.3[医药卫生—临床医学]