神经内镜辅助下经乙状窦后入路显微手术切除大中型听神经瘤  

Clinical efficacy of endoscope-assisted microsurgery via retrosigmoid approach for medium to large vestibular schwannomas

作　　者：杨振兴[1] 熊晓星[1] 杜立[2] 简志宏[1] YANG Zhen-xing;XIONG Xiao-xing;DU Li;JIAN Zhi-hong(Department of Neurosurgery,Renmin Hospital of Wuhan University,Wuhan 430060,China)

机构地区：[1]武汉大学人民医院神经外科,武汉430060 [2]武汉大学人民医院麻醉科,武汉430060

出　　处：《中国临床神经外科杂志》2022年第12期970-973,976,共5页Chinese Journal of Clinical Neurosurgery

基　　金：国家自然科学基金(81870939);中央高校基础研究基金(2042022kf1216)。

摘　　要：目的探讨神经内镜辅助下经乙状窦后入路显微手术切除大中型听神经瘤的效果。方法回顾性分析2019年5月至2022年5月神经内镜联合显微镜经乙状窦后入路手术治疗的16例大中型听神经瘤的临床资料。结果16例肿瘤均全切除,面神经解剖保留14例(87.5%),术后面神经功能依据House-Brackmann分级Ⅰ级5例,Ⅱ级6例,Ⅲ级3例。术后无脑脊液漏及颅内感染。术后随访3~24个月,复查MRI增强未见肿瘤复发。结论神经内镜辅助显微手术切除切除大中型听神经瘤,有助于减少手术创伤,减少脑脊液漏等并发症,保护面听神经功能,提高肿瘤全切除率。Objective To investigate the clinical efficacy of endoscope-assisted microsurgery(EAM)via retrosigmoid(RS)approach for patients with medium to large vestibular schwannoma.Methods A retrospective analysis of the clinical data 16 patients with medium to large vestibular schwannoma who underwent EAM through the RS approach from May 2019 to May 2022 were analyzed retrospectively.Results Tumors were completely removed in all 16 patients,and the facial nerves were anatomically preserved in 14 patients(87.5%).There was no postoperative cerebrospinal fluid leakage or intracranial infection.House-Brackmann gradeⅠwas achieved in 5 patients,gradeⅡin 6,and gradeⅢin 3 after the operation.The follow-up ranged from 3 months to 24 months.MRI showed no tumor recurrence during the follow-up.Conclusions For the patients with a medium to large vestibular schwannoma,EAM via RS approach is helpful in reducing the surgical trauma,reducing cerebrospinal fluid leakage and other complications,protecting the auditory and facial nerve function,and improving the rate of total tumor resection.

关 键 词：听神经瘤 显微手术 乙状窦后入路 神经内镜 内听道 面神经保护 

分 类 号：R739.41[医药卫生—肿瘤] R651.11[医药卫生—临床医学]