發(fā)布時(shí)間：2018-12-29 17:22

【摘要】：目的：評(píng)價(jià)經(jīng)枕下乙狀竇后經(jīng)內(nèi)聽(tīng)道入路,術(shù)中神經(jīng)電生理監(jiān)測(cè)下顯微手術(shù)切除聽(tīng)神經(jīng)瘤的療效。 方法：本組回顧性分析了94例聽(tīng)神經(jīng)瘤的病例,均采用枕下乙狀竇后經(jīng)內(nèi)聽(tīng)道入路行顯微手術(shù)切除,術(shù)中均行神經(jīng)電生理監(jiān)測(cè)。 結(jié)果：本組腫瘤全切除93例(98.9%)；次全切除1例(1.1%)；面神經(jīng)解剖保留94例(100%)；巖靜脈解剖保留91例(96.8%)；聽(tīng)力保留14例/71例(19.7%)；無(wú)死亡病例。 結(jié)論：1.顯微外科手術(shù)是治療聽(tīng)神經(jīng)瘤的一種安全有效的方法。 2.通過(guò)采取枕下乙狀竇后經(jīng)內(nèi)聽(tīng)道入路,術(shù)中配合良好的神經(jīng)電生理監(jiān)測(cè)技術(shù)及熟練的顯微外科操作技巧,有助于提高聽(tīng)神經(jīng)瘤的全切率、面聽(tīng)神經(jīng)功能保留率及巖靜脈的保留率,術(shù)后注意并發(fā)癥的防治,從而使絕大多數(shù)聽(tīng)神經(jīng)瘤患者獲得滿意的臨床療效。 3.腫瘤的大小是影響術(shù)后面神經(jīng)功能的重要因素。 4.對(duì)于技術(shù)成熟的術(shù)者,小型聽(tīng)神經(jīng)瘤仍首選顯微手術(shù)治療。
[Abstract]:Objective: to evaluate the effect of microsurgical resection of acoustic neuroma by transoccipital retrosigmoid sinus approach and intraoperative neurophysiological monitoring. Methods: 94 cases of acoustic neuroma were retrospectively analyzed. All the patients underwent microsurgical resection through the internal auditory canal through the suboccipital sigmoid sinus. The electrophysiological monitoring was performed during the operation. Results: there were 93 cases (98.9%) of total tumor resection, 1 case (1.1%) of subtotal resection, 94 cases (100%) of anatomic preservation of facial nerve, 91 cases (96.8%) of anatomic preservation of petrosal vein. There were 14 cases (19.7%) with hearing retention and no death. Conclusion: 1. Microsurgery is a safe and effective method for the treatment of acoustic neuroma. 2. By adopting the retrosigmoid sinus approach through the internal auditory canal, good neuroelectrophysiological monitoring technique and skillful microsurgical techniques, the total removal rate of acoustic neuroma can be improved. The preservation rate of facial acoustic nerve function and the preservation rate of petrosal vein and the prevention and treatment of postoperative complications made the majority of patients with acoustic neuroma obtain satisfactory clinical effect. 3. Tumor size is an important factor affecting facial nerve function after operation. 4. Microsurgery is still the preferred treatment for small acoustic neuroma for mature surgical operators.
【學(xué)位授予單位】：中南大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2014
【分類號(hào)】：R739.4

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