2型神经纤维瘤病前庭神经鞘瘤的显微外科治疗  

Microsurgical treatment of vestibular schwannoma in patients with neurofibromatosis type 2

作　　者：赵赋[1] 王博[2] 杨智君[2] 王振民 吴胜田[2] 李智[2] 张晶[1] 汪颖[1] 王兴朝[2] 刘丕楠[2] 

机构地区：[1]首都医科大学北京市神经外科研究所,100050 [2]首都医科大学附属北京天坛医院神经外科 [3]不详

出　　处：《中华神经外科杂志》2014年第11期1153-1156,共4页Chinese Journal of Neurosurgery

基　　金：十二五国家科技支撑计划（2012BAI12B03）;国家自然科学基金（81372715）;北京市自然科学基金（7112049）

摘　　要：目的 探讨2型神经纤维瘤病（NF2）前庭神经鞘瘤的显微外科治疗策略和疗效评价.方法 回顾性分析了90例NF2患者的病例资料、影像学及听力学表现,手术均采用枕下乙状窦后入路切除前庭神经鞘瘤,术中采用面神经、三叉神经和听性脑干反应（ABR）监测.结果 肿瘤全切除78例,近全切除9例,次全切除3例,未全切病例66.7％ （8/12）为患者唯一存在听力耳;面神经解剖保留85例,面神经功能H-B分级Ⅰ～Ⅲ级57例;按AAO-HNS分级标准,B组患者20例,C组12例,D组58例.结论 显微外科手术是治疗NF2前庭神经鞘瘤的有效方法,肿瘤切除时应尽可能保留神经功能,提高患者长期生存质量.Objective To study surgical treatment strategies and outcomes of bilateral vestibular schwannomas（VS） in neurofibromatosis （NF）type 2 patients.Methods Retrospective study 90 cases of clinical information,imaging and of neurofibromatosis type 2 patients.Suboccipital approach was taken for 90 cases of VS resection and intraoperative monitoring of the facial and trigeminal nerves and auditory brainstem responses （ABR） was used in all cases.Results Total tumor resection was achieved in 78 cases.Near total and sub-total resection were be done in 9 and 3 cases,as 8 of 12 was the only hearing ear.As more than 1-year follow-up,the anatomical integrity of the facial nerve was preserved in 85 cases.59 cases had Ⅰ-Ⅲ grade of H-B Score.Postoperative hearing level Analysis according to AAO-HNS grade showed that hearing was preserved in 20 of 90 cases for Class B,12 cases for Class C and in 58 cases for Class D.Conclusion Vestibular schwannomas in NF2 can be successfully treated with microsurgical treatment.Neurological function should be presevered as good as possible for the patients＇s quality of life.

关 键 词：前庭神经鞘瘤 2型神经纤维瘤病 显微外科手术 治疗策略 

分 类 号：R739.4[医药卫生—肿瘤]