听神经鞘瘤的显微手术策略

摘要

目的 总结听神经鞘瘤(AN)的显微手术治疗策略.方法 回顾分析38例在神经电生理监测下进行显微外科切除的AN患者临床资料.结果 38例患者肿瘤切除程度:全切27例(79.45％),次全切除10例(15.07％),大部切除4例(5.48％),术后死亡2例(2.74％).面神经解剖保留70例(95.89％),术后患者面神经功能能评定:Ⅰ～Ⅱ级54例(73.9％),Ⅲ～Ⅳ级16例(21.9％),Ⅴ～Ⅵ级1例(1.4％).结论 良好的显微手术技巧可以有助于切除AN,神经电生理监测有助于提高AN患者面神经术中面神经保留率.%Objective To summarize the microsurgery methods of the acoustic neurilemoma.Methods The clinic data of 38 acoustic neurilemoma patients,who were treated by microsurgery under the nerve electrophysiologic monitor,were analyzed retrospectively.Resuits Among 38 patients cases,27(71％) cases were totally resected,10(26％)subtotally,1(3％) in greater part,and 1(3％) were postoperatively dead.The facial nerve was kept anatomic intact in 32 cases (84％),and the postoperative facial nerve grading was:grade Ⅰ to Ⅱ in 28(73％),grade Ⅲ to Ⅳ in 3 (8％),and grade Ⅴ to Ⅵ in 7 (19％).Conclusion Nicer microsurgery skill could be favorable to resect the acoustic neurilemoma.The nerve electrophysiologic monitoring could be favorable in keeping the anatomic intact of the operating facial nerve of the patients.