Background:Total removal of the vestibular schwannoma when preserving the function of the facial nerve is difficult.The objective of the current study was to investigate the short-term clinical outcome of vestibular s...Background:Total removal of the vestibular schwannoma when preserving the function of the facial nerve is difficult.The objective of the current study was to investigate the short-term clinical outcome of vestibular schwannoma removal via retro-sigmoid approach.Methods:One-hundred consecutive patients diagnosed with vestibular schwannoma were surgically treated between December 2018 and August 2019 in Xuanwu Hospital,Capital Medical University.The clinical classification,surgical position,gross total removal rate,the anatomical and functional preservation rates of facial nerve,and the postoperative complications were retrospectively analyzed.Results:All 100 patients including 34 males and 66 females were operated on via retro-sigmoid approach.According to Koos vestibular schwannoma grading system,18 cases were grade 2,34 cases were grade 3,and 48 cases were grade 4.According to Hannover vestibular schwannoma grading system,5 cases were T2,6 cases were T3a,8 cases were T3b,30 cases were T4a,and 51 cases were T4b.Seventy-three surgeries were performed under lateral position,and 27 cases were operated under semi-sitting position.The gross total removal rate was 90.0%;the anatomic reservation rate of the facial nerve was 96.0%.According to the House-Brackman system,the facial nerve function was grades 1-2 in 78.0%cases,grade 3 in 7.0%cases,and grades 4-5 in 15%cases.For patients with effective hearing before operation,the hearing reservation rate was 19.0%.Two patients(2.0%)developed intracranial hematoma after operation.Conclusion:Most vestibular schwannoma could be completely removed with good postoperative facial nerve function.If total removal of tumor is difficult,we should give priority to the functional preservation of the nerve function.展开更多
目的 探讨 3D CISS序列内耳及内听道成像技术及临床应用。方法 对 3 0例共 60只耳应用 3D CISS序列做颞骨容积扫描 ,采用多平面重建 (MPR)及最大强度投影 (MIP)行后处理 ,观察 3D CISS序列对内耳及内听道解剖结构及病变的显示。结果 ...目的 探讨 3D CISS序列内耳及内听道成像技术及临床应用。方法 对 3 0例共 60只耳应用 3D CISS序列做颞骨容积扫描 ,采用多平面重建 (MPR)及最大强度投影 (MIP)行后处理 ,观察 3D CISS序列对内耳及内听道解剖结构及病变的显示。结果 3D CISS序列扫描结合MPR及MIP重建对内耳迷路及内听道内神经及血管显示清晰 ,能够清晰显示病变与周围结构的关系 ,MPR重建对神经的显示优于MIP重建。结论 3D CISS序列对内耳及内听道的结构及病变显示清晰 ,具有较高的临床应用价值。展开更多
目的分析内听道重复畸形(duplication of the internal auditory canal,DIAC)患者CT及MRI影像学表现,提高对该畸形的认识,为人工耳蜗植入提供术前依据。方法回顾性观察20例(24耳)DIAC患者内耳多层螺旋CT(MSCT)及MRI资料,测量并分析病变...目的分析内听道重复畸形(duplication of the internal auditory canal,DIAC)患者CT及MRI影像学表现,提高对该畸形的认识,为人工耳蜗植入提供术前依据。方法回顾性观察20例(24耳)DIAC患者内耳多层螺旋CT(MSCT)及MRI资料,测量并分析病变组与对照组内听道及蜗神经孔宽度。结果DIAC均为内听道狭窄及合并其他颞骨畸形。MSCT示21耳、MRI水成像示16耳内听道由骨性分隔成双管。MRI水成像示前庭蜗神经纤细。病变、对照组内听道宽度及蜗神经孔宽度均有统计学差异(P<0.001)。6例(8耳)行人工耳蜗植入术后听力均有不同程度恢复。结论DIAC均显示内听道狭窄,MSCT所示骨性分隔为其特征性征象,MRI水成像示前庭蜗神经发育不良,联合两种影像检查方法可为本病诊断和人工听觉植入提供客观参考依据。展开更多
基金supported by National Key R&D Program of China(2021YFC2400803)
文摘Background:Total removal of the vestibular schwannoma when preserving the function of the facial nerve is difficult.The objective of the current study was to investigate the short-term clinical outcome of vestibular schwannoma removal via retro-sigmoid approach.Methods:One-hundred consecutive patients diagnosed with vestibular schwannoma were surgically treated between December 2018 and August 2019 in Xuanwu Hospital,Capital Medical University.The clinical classification,surgical position,gross total removal rate,the anatomical and functional preservation rates of facial nerve,and the postoperative complications were retrospectively analyzed.Results:All 100 patients including 34 males and 66 females were operated on via retro-sigmoid approach.According to Koos vestibular schwannoma grading system,18 cases were grade 2,34 cases were grade 3,and 48 cases were grade 4.According to Hannover vestibular schwannoma grading system,5 cases were T2,6 cases were T3a,8 cases were T3b,30 cases were T4a,and 51 cases were T4b.Seventy-three surgeries were performed under lateral position,and 27 cases were operated under semi-sitting position.The gross total removal rate was 90.0%;the anatomic reservation rate of the facial nerve was 96.0%.According to the House-Brackman system,the facial nerve function was grades 1-2 in 78.0%cases,grade 3 in 7.0%cases,and grades 4-5 in 15%cases.For patients with effective hearing before operation,the hearing reservation rate was 19.0%.Two patients(2.0%)developed intracranial hematoma after operation.Conclusion:Most vestibular schwannoma could be completely removed with good postoperative facial nerve function.If total removal of tumor is difficult,we should give priority to the functional preservation of the nerve function.
文摘目的 探讨 3D CISS序列内耳及内听道成像技术及临床应用。方法 对 3 0例共 60只耳应用 3D CISS序列做颞骨容积扫描 ,采用多平面重建 (MPR)及最大强度投影 (MIP)行后处理 ,观察 3D CISS序列对内耳及内听道解剖结构及病变的显示。结果 3D CISS序列扫描结合MPR及MIP重建对内耳迷路及内听道内神经及血管显示清晰 ,能够清晰显示病变与周围结构的关系 ,MPR重建对神经的显示优于MIP重建。结论 3D CISS序列对内耳及内听道的结构及病变显示清晰 ,具有较高的临床应用价值。
文摘目的分析内听道重复畸形(duplication of the internal auditory canal,DIAC)患者CT及MRI影像学表现,提高对该畸形的认识,为人工耳蜗植入提供术前依据。方法回顾性观察20例(24耳)DIAC患者内耳多层螺旋CT(MSCT)及MRI资料,测量并分析病变组与对照组内听道及蜗神经孔宽度。结果DIAC均为内听道狭窄及合并其他颞骨畸形。MSCT示21耳、MRI水成像示16耳内听道由骨性分隔成双管。MRI水成像示前庭蜗神经纤细。病变、对照组内听道宽度及蜗神经孔宽度均有统计学差异(P<0.001)。6例(8耳)行人工耳蜗植入术后听力均有不同程度恢复。结论DIAC均显示内听道狭窄,MSCT所示骨性分隔为其特征性征象,MRI水成像示前庭蜗神经发育不良,联合两种影像检查方法可为本病诊断和人工听觉植入提供客观参考依据。
