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目的:探讨内镜辅助在行乙状窦后径路听神经瘤切除术中的应用和意义。方法:在内镜辅助下经乙状窦后径路听神经瘤切除术12例,术中行面、听神经监测,手术前后面听功能评估,并与未采用内镜辅助的乙状窦后径路手术进行综合比较。结果:12例听神经瘤完全切除,手术完成顺利,术后无并发症。术中面听神经均获解剖保留,术中神经监测以观测面听神经功能保留情况,术后半年面神经功能与术前相比无明显改变,所有患者听觉功能与术前相比均有不同程度下降。内镜辅助下手术组术后面神经功能及听觉功能改变与未采用内镜辅助手术组差异无统计学意义。结论:在乙状窦后径路手术中应用内镜辅助能为桥小脑角区手术提供精确的信息,在避免后半规管、颈静脉球损伤的前提下,完全切除内耳道底的肿瘤,减少并发症的发生,但对面听神经功能保留无明显作用。
Objective: To explore the application and significance of endoscopic assisted resection of acoustic neuromas in the posterior approach of sigmoid sinus. Methods: 12 patients underwent endoscopic retrosigmoid surgery for acoustic neuroma resection, underwent surgery, auditory nerve monitoring, face-to-face hearing assessment before and after surgery, and were combined with endoscopic-assisted sigmoid sinus surgery Compare Results: 12 cases of acoustic neuroma were completely resected, and the operation was completed smoothly with no postoperative complications. During the operation, the auditory nerve was preserved in the anatomy. The intraoperative nerve monitoring was performed to observe the preservation of the auditory nerve function. The facial nerve function after six months had no significant change compared with that before operation. All the patients had decreased auditory function compared with that before operation. No significant difference was found in the changes of facial nerve function and auditory function between the endoscopic-assisted surgery group and the non-endoscopic assisted surgery group. CONCLUSIONS: Endoscopic assisted surgery in the sigmoid sinus posterior approach provides precise information for the cerebellopontine angle region. With the precondition of avoiding the posterior semicircular canal and jugular bulb injury, resection of the inner ear canal tumor is completed and complications are reduced Of the occurrence, but the opposite auditory nerve function retention no significant effect.