作者报告大型听神经瘤经中颅窝小脑幕一迷路联合侧方入路手术方法,该入路能较满意地达到全切肿瘤和保留面神经功能的目的.方法:患者仰卧,头向健侧旋转90°使颞鳞呈水平位.头皮切口自乳突开始,向上环绕外耳,到颧弓为止.而后经迷路解剖,切除内听道的上、下、后壁,上内侧切除岩骨尖端,向下显露至颈静脉球,上方把顶盖修薄,后方将后颅窝硬膜上方的骨质完全切除,显露乙状窦.作一颞部小骨瓣.将复盖在迷路上方残留的中颅窝底骨质完全去除,前内侧到岩上窦为止.垂直切开颞叶表面的硬膜,注意避开来自颞叶侧、下方的静脉,硬膜切口向下越过中颅窝底直至岩上窦.垂直切开后颅窝硬膜,下抵颈静脉球,上达岩上窦,在两把止血钳间切断岩上窦.切开小脑幕至切迹,该处可见中脑和第四颅神经,且多能从环池流出多量 The authors reported that large acoustic neuromas were treated through the midcranial fossa-cerebellum combined with a lateral labyrinth approach. This approach can satisfactorily achieve full-blown tumor and preservation of facial nerve function. Methods: The patient supine, with the head rotating to the contralateral side 90 ° Make the scales horizontal. The scalp incision starts from the mastoid process, and it surrounds the outer ear up to the zygomatic arch. Then it is dissected through the labyrinth and the upper, lower and posterior walls of the inner auditory canal are removed. Exposed to the jugular bulb, the top of the top cover thinning, the back of the posterior fossa epidural complete resection of the bone, revealing the sigmoid sinus. For a small iliac crest flap. Will cover the residual fossa above the middle of the skull fossa The bottom bone is completely removed, the anteromedial to the superior sinus. Vertically cut the dural surface of the temporal lobe, pay attention to avoid the veins from the temporal lobe and the inferior vein, and the dural incision passes over the middle cranial fossa to the superior sinus. Vertical After incision, the posterior fossa dura mater, under the jugular venous sinus, up to the superior sinus, cut off the petrous sinus between the two hemostats, cut the tentorium to the notch, where the midbrain and the fourth cranial nerve can be seen. Can flow a lot from the ring pool