听神经瘤手术切除术中面神经电生理监测与保护  

Face nerve monitor techniques use during cerebellopontine angle tumour microsurgical surgery and review analysis

作　　者：刘会林[1] 邓大丽[2] 喻廉[1] 王黎[1] 

机构地区：[1]合肥安徽医科大学附属安徽省立医院立体定向神经外科研究所,230061 [2]合肥安徽医科大学附属安徽省立医院神经内科,230061

出　　处：《安徽医学》2012年第3期263-265,共3页Anhui Medical Journal

基　　金：安徽省卫生厅临床医学应用技术项目(项目编号:2008B033)

摘　　要：目的分析听神经瘤患者术中面神经监测技术以及在显微外科联合应用的手术中面神经保留、预后情况分析。方法安徽医科大学附属省立医院手术切除179例听神经瘤患者,对术中面神经监测情况以及术后面神经保留情况的回顾性分析。结果 179例听神经瘤患者,术后面神经功能保留率83%,解剖保留率96%;其中听神经瘤最大直径大于等于4.0 cm有88例,小于4.0 cm 91例。结论随着人们生活质量不断的提高,听神经瘤治疗目的不再仅仅是切除肿瘤延长生命,而是要求在尽可能彻底切除肿瘤的同时完整保留面神经功能作为听神经瘤治疗最佳效果。术中面神经监测技术和显微内镜的联合应用,以及手术者经验的不断丰富,可以大大提高听神经瘤手术时面神经保留率。Objective To study nerve monitor techniques use in the cerebellopontine angle tumour microsurgical surgery.Methods One hundred and seventy-nine patients with acoustic neuromas,admitted to our hospital from Jan 1 to Dec 30,were restrospectively analyzed.Acoustic neurinomas was removed with suboccipital retrosigmoid approach and microsurgical technique,during face nerve EMG monitoring.The facial nerve was stimulated current at the end of operation.Results Total separation was achieved in 179 patiens.The function of facial nerve was preserved in 148 cases（83%） and the facial nerve was preserved anatomically in 172 cases（96%）.AN≤4 cm was in 91 patients and AN4 cm in 88 patients.Conclusion With the quality of life rising,the treatment of acoustic neuromas would be no longer merely resection and demand of prolonging life,but also protecting facial nerve.Application of intraoperative facial nerve monitoring jointing with microscopic endoscopic can greatly prevent facial nerve damage during resection of acoustic neuromas.

关 键 词：听神经瘤 面神经肌电图 面神经功能评价 显微外科 

分 类 号：R739.4[医药卫生—肿瘤]