大型听神经瘤迷路径路手术中外耳道及鼓室的处理

摘要

目的讨论大型听神经瘤迷路径路手术中外耳道及鼓室的处理方法.方法对115例经迷路径路切除大型听神经瘤的临床病例资料进行总结,分析外耳道和鼓室的处理方法,其中96例术中保留外耳道后壁,19例术中切除外耳道并填塞中耳.结果115例大型听神经瘤均采用迷路径路,肿瘤全切除103例(89.6%),近全切除9例(7.8%),次全切除3例(2.6%)；术后脑脊液漏8例,发生率7.0%.结论通过迷路径路切除大型听神经瘤能取得良好的手术效果,术中外耳道和鼓室的正确处理能够获得良好的手术显露,并能够有效的降低脑脊液漏的发生率.%Objective The present study is a retrospective analysis of management of external auditory canal and tympanic cavity in translabyrinthine approach for large acoustic neuroma. Methods One hundred and fifteen acoustic neu⁃romas were surgically removed via translabyrinthine approach between January 2001 and December 2010. The manage⁃ment of external auditory canal and tympanic cavity was reviewed. Results Total, near total, and subtotal tumor removal rate was 89.6%, 7.8%and 2.6%, respectively. Cerebrospinal fluid leakage occurred in 8 patients (7.0%). Conclusions Sur⁃gical removal of large acoustic neuroma via translabyrinthine approach can yield good postoperative outcomes. Proper man⁃agement of external auditory canal and tympanic cavity can provide maximal surgical exposure and effectively reduce occur⁃rence of cerebrospinal fluid leakage.