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目的 :总结应用显微外科技术切除大型听神经瘤的治疗方法。方法 :对 40例大型听神经瘤采用显微外科技术行肿瘤切除术 ,其中 1 3例经单侧枕下旁正中入路 ,其余 2 7例为枕下乙状窦后入路。结果 :肿瘤全切 3 4例 ,占 85 % ,次全切 5例 ,大部切除 1例。全组无手术死亡。面神经解剖保留率为 90 % (3 6 / 40 ) ,耳蜗神经解剖保留率为 2 5 % (9/ 40 )。根据House- Brackmann面神经功能分级标准 ,随访 2 3例 , ～ 级 1 1例 (48% ) , ～ 级 9例(3 9% ) , ～ 级 3例 (1 3 % )。结论 :绝大部分大型听神经瘤可经显微外科手术切除 ,手术时应力争面神经和听力保留
Objective: To summarize the application of microsurgical techniques in the treatment of large acoustic neuromas. Methods: Forty patients with large acoustic neuroma underwent microsurgical resection of the tumor. Among them, 13 cases underwent unilateral suboccipital approach and the remaining 27 cases underwent suboccipital sigmoid sinus approach. Results: Totally 34 cases of tumors were completely resected, accounting for 85%, subtotally resected in 5 cases and most resected in 1 case. The whole group died without surgery. Facial nerve anatomy retention rate was 90% (36/40), cochlear nerve anatomy retention rate of 25% (9/40). According to the House-Brackmann facial nerve function grading criteria, 23 cases were followed up, 1 case (~ 48%) ~ ~ 9 cases (~ 9%) ~ 3 cases (~ 13%). Conclusion: The vast majority of large acoustic neuromas can be surgically removed by microsurgery, surgery should stress facial nerve and hearing retention