摘要
目的探讨经中颅窝入路切除内听道听神经瘤的手术技巧与效果。方法回顾性分析2012年1月至2015年12月空军军医大学唐都医院神经外科收治的10例内听道听神经瘤患者的临床资料。所有患者均采用经中颅窝入路切除听神经瘤。分别采用美国耳鼻咽喉头颈外科学会的标准（AAO—HNS分级）和House—Braekmann面神经功能分级（简称H—B分级）评估术前、术后听神经和面神经的功能。结果所有患者的肿瘤均达到全切除。术后无一例发生脑脊液漏。1例术后发生颅内感染，无死亡病例。术后6～12个月复查MRI，结果显示所有患者均未出现肿瘤复发。10例患者术后3个月的有效听力保存（A或B级）比例达4／5，术后6—12个月H—B分级Ⅰ、Ⅱ级的比例达9／10。结论对于内听道内听神经瘤，采用经中颅窝入路手术是保留患者听力和面神经功能的有效方法，熟悉经中颅窝入路的解剖结构及手术技巧有助于降低手术并发症、提高听力保留率。
Objective To investigate the surgical outcomes and techniques of middle fossa （MF） approach for resection of intracanalicular vestibular schwannomas. Methods Ten patients diagnosed with intracanalicular vestibular schwannoma underwent surgery treatment through MF approach at Department of Neurosurgery, Tangdu Hospital, Airforce Military Medical University from January 2012 to December 2015. The effects of surgery on hearing and facial nerve functions were assessed according to American Academy of Otolaryngology-Head and Neck Surgery （AAO-HNS） classification and House-Brackmann （H-B） grading system, respectively. Results All patients achieved complete resection of tumor. Intracranial infection occurred in 1 case. There was no death or cerebrospinal fluid （CSF） leakage. The MRI results at 6 - 12 months post surgery suggested no recurrence of tumor. The rate of postoperative effective hearing （class A/ B） preservation was 4/5, and the rate of functional facial nerve （class Ⅰ/Ⅱ） preservation rate was 9/10. Conclusions For intracanalicular vestibular schwannomas, microsurgery via the MF approach could offer good preservation of hearing and facial nerve functions. Being familiar with the anatomy and techniques of MF approach would help to reduce the operative complications.
出处
《中华神经外科杂志》
CSCD
北大核心
2018年第1期21-25,共5页
Chinese Journal of Neurosurgery
基金
国家自然科学基金（81200902,81572470）
陕西省自然科学基金青年人才项目（S2015YFJQ1250）
第四军医大学精英人才项目（4139C4IA36）
唐都医院临床新技术新业务资助项目
关键词
神经瘤
听
神经外科手术
内听道
经中颅窝入路
听力保留
Neuroma, acoustic
Neurosurgical procedures
Internal acoustic canal
Middle fossa approach
Hearing preservation
