从裸眼到显微外科听神经瘤切除术的个人经验  

Individual experience in acoustic neuroma surgery: from direct vision surgery to microsurgery

作　　者：刘绍明[1] 李龄[2] 熊志刚[1] 曹天锡[1] 

机构地区：[1]中国人民解放军兰州军区乌鲁木齐总医院神经外科,新疆乌鲁木齐830000 [2]华中科技大学同济医学院附属同济医院神经外科,湖北武汉430030

出　　处：《中国微侵袭神经外科杂志》2004年第2期71-73,共3页Chinese Journal of Minimally Invasive Neurosurgery

摘　　要：目的总结从裸眼直视手术过渡到显微外科进行听神经瘤切除术的个人经验。方法将个人十余年收治的32例听神经瘤病人资料,分作前期的直视手术组(14例)和后期的显微外科组(18例)进行回顾分析。结果在病人条件大致相同的情况下,采用显微外科听神经瘤手术疗效大为提高。全切率为88.9%,87.5%面神经解剖保全,术后听力保存占33.3%。结论显微外科是保证听神经瘤手术取得满意疗效的前提。规范和提高听神经瘤手术技术标准是我们必须加以重视的问题。Objective To summarize the individual experience in surgery of acoustic neuroma, by which from direct vision surgery (DVS) to microsurgery (MS). Methods 32 cases of acoustic neuromas treated in last 13 years was classified into two groups, first 14 cases were operated by DVS before 1993 and the other 18 cases by MS after. The clinical data of all patients were studied retrospectively. Results Under almost alike circumstances, by MS, the tumor complete resection rate was 88.9%, the facial nerve anatomic preservation rate was 87.5%, and early hearing preservation postoperatively was 33.3%. Conclusion Microsurgery is an essential prerequisite to ensure satisfactory outcome of acoustic neuroma surgery. The basic standard is to remove the tumors completely for once, preserve the facial nerve anatomically and functionally, and further attempt is to preserve hearing. It should be laid stress on how to improve and standardize the criteria of acoustic neuroma surgery now in China.

关 键 词：听神经瘤 手术治疗 显微外科 显微解剖 脑积水 手术入路 

分 类 号：R739.41[医药卫生—肿瘤] R730.56[医药卫生—临床医学]