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目的探讨听神经瘤显微外科手术中面神经保留技术方法21例听神经瘤患者,采用枕下开颅乙状窦后入路,显微外科切除肿瘤。在面神经监护下,观察肿瘤与面神经的病理解剖关系,术后随访时间9～29个月。结果肿瘤全切除19例,次全切除3例。面神经解剖保留20例,解剖未能保留成功2例,其中1例术中行面神经端-端吻合。结论面神经监测技术,娴熟的显微外科技术、病理解剖知识对面神经保留的至关重要。
Objective To investigate the method of facial nerve retention in acoustic neuroma microsurgery in 21 patients with acoustic neuroma. Subacute posterior sigmoid sinus posterior approach and microsurgical resection of the tumor were performed. Under facial nerve monitoring, observe the pathological anatomy of the tumor and facial nerve, postoperative follow-up time 9 to 29 months. Results Totally resected tumor in 19 cases, subtotal resection in 3 cases. Facial nerve anatomy retained in 20 cases, anatomical failure to retain 2 cases, of which 1 case of facial nerve end-to-end anastomosis. Conclusion Facial nerve monitoring techniques, skilled microsurgical techniques, and pathological anatomy are crucial for facial nerve preservation.