经枕下乙状窦后入路显微手术切除32例大型听神经瘤  

A Study of 32 Cases of Microsurgical Resection for Large Acoustic Neuromas by Suboccipital Retrosigmoid Approach

作　　者：赵红[1] 郑丽[2] 徐广帅[3] 

机构地区：[1]菏泽医学专科学校耳鼻咽喉教研室,山东菏泽274000 [2]辽宁医学院药学院,辽宁锦州121001 [3]辽宁医学院教务处,辽宁锦州121001

出　　处：《辽宁医学院学报》2012年第5期416-419,共4页Journal of Liaoning Medical University (LNMU) Bimonthly

摘　　要：目的探讨大型听神经瘤的显微手术技巧、术中面神经功能保留的要点及术后并发症的防治,提高患者的临床疗效和生存质量。方法回顾性分析我院2008年7月至2012年7月收治的32例大型听神经瘤(直径≥3 cm)患者的临床资料和术后随访结果,32例患者均采用枕下乙状窦后入路显微外科手术治疗。结果本组32例大型听神经瘤全切29例,次全切除3例,全切率为90.6%。术中面神经解剖保留28例(87.5%),出院时面神经功能保留19例(59.4%)。结论熟练地掌握显微外科技术、选择合适的手术入路、预防和正确处理术后并发症是有效提高听神经瘤手术效果的关键。Objective To evaluate the microsurgical techniques for large acoustic neuromas,skills of facial nerve preservation and prevention of postoperative complications,so that to improve the clinical efficacy and living quality of patients.Methods The clinical and postoperative follow-up data of the 32 patients with large acoustic neuromas（maximum diameter greater than 30 mm） collected from July 2008 to July 2012 were retrospectively analyzed.All of the 32 patients were treated by microsurgery via suboccipital retrosigmoid approach.Results Among the 32 cases,tumors of 3 patients were partly removed,while 29 were completely removed,accounting for 90.6% of the total.Facial nerves of patients in 28 cases were preserved in the operation,17 of which were still with facial nerve preserved at discharge.Conclusion The proficiency in microsurgical techniques,the appropriate surgical approach and the proper prevention and treatment of postoperative complications are critical to improve the effectiveness of surgery for acoustic neuromas.

关 键 词：听神经瘤 面神经 显微神经外科 桥小脑角 并发症 

分 类 号：R764.4[医药卫生—耳鼻咽喉科]