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目的探讨听神经瘤显微手术治疗和面听神经功能保护的疗效。方法分析1999年10月至2002年10月收治经枕下乙状窦后内听道入路手术切除30例听神经瘤的资料,全部病例采用保留面听神经功能的显微外科技术。结果听神经瘤手术全切除29例(96.7%),次全切除1例;面神经解剖保留25例(83.3%),手术后12周面神经功能保留21例(70%);耳蜗神经解剖保留25例83.3%),手术后2周有效听力保留2例(占术前存在有效听力患者的28.6%),有效听力丧失但可测听力保留15例。结论枕下乙状窦后经内听道入路的听神经显微手术,能够取得较好的肿瘤全切除率和面听神经功能保留率。
Objective To investigate the effects of microsurgical treatment of acoustic neuroma and facial nerve function protection. Methods The data of 30 patients with acoustic neuroma underwent transoccipitated sigmoid sinus surgery from October 1999 to October 2002 were retrospectively analyzed. All the cases were treated by microsurgical technique with preserved facial nerve function. Results The total resection of acoustic neuroma was performed in 29 cases (96.7%) and subtotal resection in 1 case. Facial nerve anatomy retained 25 cases (83.3%). Facial nerve function remained at 21 weeks after surgery in 21 cases (70%). Cochlear nerve anatomy retained 25 cases (83.3% %), Effective hearing preservation 2 weeks after surgery (accounting for 28.6% of patients with effective hearing before surgery), effective hearing loss but measurable hearing retention in 15 cases. Conclusion Microsurgery of the suboccipital sigmoid sinus through the internal auditory canal leads to better tumor resection rate and facial nerve preservation rate.