作　　者： (张申起）; (彭彬）; (陈治标）; (田道锋）; (王军民）; (刘宝辉）; (杨吉安）; (陈谦学）;

机构地区： 武汉大学人民医院神经外科,武汉430060

出　　处： 《中国临床神经外科杂志》 2017年第8期529-532,共4页

摘　　要： 目的探讨在术中神经电生理监测下经枕下-乙状窦后入路显微手术切除大型听神经瘤的方法及效果。方法回顾性分析2013年1月至2015年10月收治的85例大型听神经瘤的临床资料,均在术中神经电生理监测下,采取直切口乙状窦后入路小骨窗显微手术切除肿瘤。结果肿瘤全切除76例(89.4%),次全切除9例(10.6%);术中面神经解剖保留80例(94.1%)。术后即刻、7 d、3个月、6个月、9个月、1年面神经功能分级优良率(H-B分级Ⅰ~Ⅱ级)分别为88.2%、56.0%、41.9%、50.9%、68.6%、86.7%。结论在术中神经电生理监测下显微手术治疗大型听神经瘤,可更好保护面神经功能,提高术后生活质量。 Objective To explore the surgical technique of large vestibular schwannomas(LVS)and methods of intraoperative protection of facial nerve.Methods A retrospective analysis of clinical data of85patients with LVS,who underwent the microsurgery via suboccipital retrosigmoid approach under the electrophysiological monitoring from January,2013to October,2015in Department of Neurosurgery of Renmin Hospital of Wuhan University,was made.Results The total resection of the tumors was achieved in76patients with LVS(89.4%)and subtotal in9(10.6%).The facial nerves were anatomically reserved in80patients with LVS(94.1%).The excellent rate of the facial nerve function(House-Brackmann classification gradesⅠ~Ⅱ)immediately,7days,3,6and9months and1year after the surgery were88.2%,56.0%,41.9%,50.9%,68.6%,and86.7%,respectively.Conclusions The surgery via suboccipital retrosigmoid approach under the electrophysiological monitoring is very helpful to protection of facial nerve function and improving quality of life in the patients with LVS.

关 键 词： 大型听神经瘤 神经电生理监测 面神经功能 手术治疗