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目的 探讨显微手术切除大型听神经瘤 (L AN)的治疗效果 .方法 CT或 MRI证实位于桥脑小脑角区的直径≥31mm L AN2 16例 ,采用显微手术切除 ,术后评估治疗效果 ,分别比较术前、术后的听神经和面神经功能 .结果 肿瘤全切率 79.6 % (172例 ) ;次全切除率 15 .3% (33例 ) ;部分切除率 5 .1% (11例 ) ;术后死亡率 1.4% (3例 ) .听神经解剖学保留率为 12 .5 % (2 7例 ) ,出院时神经功能保留率为 4.2 % (A级 ,9例 ) ;面神经解剖学保留率为 82 .4% (178例 ) ,出院时神经功能保留率为 5 2 .8% (House分级 , ～ 级 94例 ) .对187例平均随访 3.9a,其中 12 8例 (6 8.4% )恢复良好 ,44例(2 3.5 % )恢复较好 ,15例 (8.0 % )恢复较差 ,后者中有 10例(5 .4% )肿瘤复发 (再次治疗后治愈 ) .结论 显微外科手术切除大型听神经瘤安全、有效
Objective To investigate the therapeutic effect of microsurgical removal of large acoustic neuroma (L AN) .Methods 16 cases of diameter ≥31 mm L AN2 in the cerebellopontine angle were confirmed by CT or MRI, and the results were evaluated by microsurgical resection Results: The total resection rate was 79.6% (172 cases), the subtotal resection rate was 15.3% (33 cases), the partial resection rate was 5.1% (11 cases) The postoperative mortality was 1.4% (n = 3), the retention rate of auditory nerve anatomy was 12.5% (27 cases), and the neurological function retention rate at discharge was 4.2% (grade A, n = 9). The facial nerve anatomy retention rate was 82 .4% (178 cases), the discharge rate of neurological function was 5.28% (House classification, ~ 94 cases) .All 187 cases were followed up for an average of 3.9 years, of which 12.8 cases (6 8.4%) recovered well, Forty-four patients (23.5%) recovered well and 15 (8.0%) patients recovered poorly, with 10 (5.4%) tumor recurrences (again cured) after microsurgery.Conclusions Microsurgical resection of large auditory nerve Tumor is safe and effective