小脑脑桥角脑膜瘤显微外科治疗及面听神经保护  

Microsurgical treatment of cerebellopontine angle meningiomas and preservation of facial nerve and auditory nerve function

作　　者：黄冠又[1] 张俊廷[1] 吴震[1] 郝淑煜[1] 张力伟[1] 贾桂军[1] 关树森[1] 

机构地区：[1]首都医科大学附属北京天坛医院神经外科,100050

出　　处：《中华神经外科杂志》2012年第7期674-677,共4页Chinese Journal of Neurosurgery

基　　金：首都医学发展科研基金（2009-1040）;卫生部公益性行业科研专项基金（200902004）;国家自然科学基金（81141028）

摘　　要：目的探讨小脑脑桥角脑膜瘤的临床分型、显微外科手术切除方法与面听神经保护。方法回顾分析经显微外科手术治疗的106例小脑脑桥角脑膜瘤，均采用枕下乙状窦后人路。结果肿瘤全切除89例（84．0％），近全切除15例（14．2％），部分切除2例（1．9％），死亡1例。面神经解剖保留101例（95．3％），听神经解剖保留75例（70．8％）。面神经功能（House—BrackmannI级、Ⅱ级）保留73例（68．9％），听力保留率为72．3％（47／65）。结论对小脑脑桥角脑膜瘤进行临床分型，选择合适的手术人路以及术中一定的手术技巧，能够提高面听神经功能保留。Objective To explore the clinical classification, microsurgical technique and intraoperative preservation of facial and auditory nerve function for cerebellopontine meningiomas. Methods 106 patients with eerebellopontine meningiomas treated with microneuro surgery were analyzed retrospectively. All Tumors resection was performed through the suboccipital retrosigmoid approach. Results Complete resection was achieved in 89 patients （ 84. 0% ）, 15 subtotal removal and 2 partial removal. One patient died after the operation. Facial nerves were anatomically preserved completely in 101 patients （95. 3% ）. Auditory nerves were anatomically preserved completely in 75 patients （70. 8% ）. The rate of the facial nerve function preservation（ House - Brackmann I , II ） was 68. 9% （73 patients）. The rate of the auditory nerve function preservation was 72. 3% （ 47/65 ）. Conclusions It is important to classify the cerebellopontine meningiomas into different clinical classifications and to choose the appropriate surgical approaches and surgical techniques, which can help to preserve the function of facial and anditoy nerve.

关 键 词：小脑脑桥角 脑膜瘤 面神经 耳蜗神经 枕下乙状窦后入路 显微外科手术 

分 类 号：R739.4[医药卫生—肿瘤]