【摘要】：目的：評價經(jīng)枕下乙狀竇后經(jīng)內聽道入路,術中神經(jīng)電生理監(jiān)測下顯微手術切除聽神經(jīng)瘤的療效。 方法：本組回顧性分析了94例聽神經(jīng)瘤的病例,均采用枕下乙狀竇后經(jīng)內聽道入路行顯微手術切除,術中均行神經(jīng)電生理監(jiān)測。 結果：本組腫瘤全切除93例(98.9%)；次全切除1例(1.1%)；面神經(jīng)解剖保留94例(100%)；巖靜脈解剖保留91例(96.8%)；聽力保留14例/71例(19.7%)；無死亡病例。 結論：1.顯微外科手術是治療聽神經(jīng)瘤的一種安全有效的方法。 2.通過采取枕下乙狀竇后經(jīng)內聽道入路,術中配合良好的神經(jīng)電生理監(jiān)測技術及熟練的顯微外科操作技巧,有助于提高聽神經(jīng)瘤的全切率、面聽神經(jīng)功能保留率及巖靜脈的保留率,術后注意并發(fā)癥的防治,從而使絕大多數(shù)聽神經(jīng)瘤患者獲得滿意的臨床療效。 3.腫瘤的大小是影響術后面神經(jīng)功能的重要因素。 4.對于技術成熟的術者,小型聽神經(jīng)瘤仍首選顯微手術治療。
[Abstract]:Objective: to evaluate the effect of microsurgical resection of acoustic neuroma by transoccipital retrosigmoid sinus approach and intraoperative neurophysiological monitoring. Methods: 94 cases of acoustic neuroma were retrospectively analyzed. All the patients underwent microsurgical resection through the internal auditory canal through the suboccipital sigmoid sinus. The electrophysiological monitoring was performed during the operation. Results: there were 93 cases (98.9%) of total tumor resection, 1 case (1.1%) of subtotal resection, 94 cases (100%) of anatomic preservation of facial nerve, 91 cases (96.8%) of anatomic preservation of petrosal vein. There were 14 cases (19.7%) with hearing retention and no death. Conclusion: 1. Microsurgery is a safe and effective method for the treatment of acoustic neuroma. 2. By adopting the retrosigmoid sinus approach through the internal auditory canal, good neuroelectrophysiological monitoring technique and skillful microsurgical techniques, the total removal rate of acoustic neuroma can be improved. The preservation rate of facial acoustic nerve function and the preservation rate of petrosal vein and the prevention and treatment of postoperative complications made the majority of patients with acoustic neuroma obtain satisfactory clinical effect. 3. Tumor size is an important factor affecting facial nerve function after operation. 4. Microsurgery is still the preferred treatment for small acoustic neuroma for mature surgical operators.
【學位授予單位】：中南大學
【學位級別】：碩士
【學位授予年份】：2014
【分類號】：R739.4

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