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目的总结25例听神经瘤显微外科手术中面神经功能保护的经验。方法对25例听神经瘤采用乙状窦后入路显微手术切除。结果肿瘤全切除20例(80%),次全切除5例;面神经解剖保留22例(88%),功能保留19例(76%),术后无死亡病例,随访3个月至5年,根据House-Brackmann面神经分级标准,15例(60%)术后3个月内面神经功能为Ⅰ~Ⅱ级,6例(24%)为Ⅲ~Ⅳ级,4例(16%)为Ⅴ~Ⅵ级。结论熟悉面神经与肿瘤的病理解剖关系,采用正确的手术处理原则,熟练掌握显微手术技巧,可提高面神经的保护功能。
Objective To summarize the experience of facial nerve function protection in 25 cases of acoustic neuroma treated by microsurgery. Methods 25 cases of acoustic neuroma undergoing sigmoid sinus posterior approach microsurgical resection. Results Twenty cases (80%) underwent total resection and 5 cases underwent subtotal resection. Facial nerve anatomy retained 22 cases (88%) and retained 19 cases (76%) with no death after operation. The patients were followed up for 3 months to 5 years, According to the House-Brackmann facial nerve grading criteria, facial nerve function was grade Ⅰ ~ Ⅱ in 15 cases (60%), grade Ⅲ ~ Ⅳ in 6 cases (24%), and grade Ⅳ ~ Ⅳ in 4 cases level. Conclusions Familiar with the pathological anatomy of facial nerve and tumor, the correct surgical treatment principle, proficiency in microsurgical skills, can improve the facial nerve function.