目的:探讨听神经瘤显微切除术中的电生理监测对面神经功能的保护作用.方法:46例听神经瘤患者分别行单纯显微镜下切除肿瘤(非监测组,22例),显微镜下切除肿瘤过程中应用术中神经监测仪对面神经进行监测(监测组,24例),观察术中面神经实时监测情况,随访所有患者术后面神经功能.结果:术后3个月根据House-Brackmann面神经功能分级对病例面瘫情况进行评价,监测组Ⅰ级21例,Ⅱ级2例,Ⅲ级1例;非监测组Ⅰ级13例,Ⅱ级5例,Ⅲ级2例,Ⅴ级2例,差异有统计学意义(P<0.05).结论:听神经瘤手术中行神经电生理监测可有效保护面神经.%Objective:To assess the value of neurophysiological monitoring in preserving the facial nerve in microsurgery for acoustic neuroma. Methods: Forty-six patients with acoustic neuroma were divided into monitoring group and non-monitoring group. The tumor was removed under the microscope without intraoperative facial nerve monitoring in 22 cases and with intraoperative monitoring in 24 cases. All the patients were followed up. Results: House-Brackmann system was used to evaluate the function of the facial nerve 3 months after the operation. Among the 24 cases in monitoring group,grade Ⅰ was observed in 21 cases,grade Ⅱ in 2 cases and grade Ⅲ in 1 case;among the 22 cases in non monitoring group,grade Ⅰ was observed in 13 cases,grade Ⅱ in 5 cases,grade Ⅲ in 2 cases and grade Ⅴ in 2 cases. The difference was significant( P ＜ 0.05 ). Conclusions: Neurophysiological monitoring may effectively preserve the facial nerve function in microsurgery for acoustic neuroma.
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