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本文报告复发听神经瘤再次手术治疗29例,无手术死亡。23例得到1～15年随访,面神经保存率55.5%。结合文献对听神经瘤术后复发的原因及再次手术问题进行了讨论。根据我们初步的粗浅体会,认为听神经瘤术后复发的根本原因是第一次手术时切除不彻底,特别是残余肿瘤的血液供应未完全阻断致日后复发;如完全阻断残余肿瘤的血液供应,术后残余瘤组织不会再继续生长,可能会被完全吸收或瘢痕化致使肿瘤不再复发。阻断血液供应,止血彻底,粘连可能会减少,残余肿瘤囊性变亦可减少发生。复发听神经瘤再次手术,并未必较初期手术在技术上的困难更加突出,其粘连程度并不象一般所想象的难以分离,故对复发听神经瘤不应轻易放弃再次手术的机会。
This report reports the recurrence of acoustic neuroma surgery again in 29 cases, no operative death. 23 cases were 1 to 15 years follow-up, facial nerve preservation rate of 55.5%. Combined with the literature on the reasons for the recurrence of acoustic neuroma and reoperation problems are discussed. According to our preliminary experience, it is considered that the fundamental reason for postoperative recurrence of acoustic neuroma is incomplete resection in the first operation. In particular, the residual tumor blood supply does not completely block the recurrence after the first episode. For example, completely block the blood supply of residual tumor , Residual tumor tissue will not continue to grow after surgery, may be completely absorbed or scarring resulting in tumor recurrence. Blocking the blood supply, hemostasis, adhesions may be reduced, residual tumor cystic change can also occur. Recurrence of acoustic neuroma surgery, surgery may not be more technical than the initial surgery more prominent, the degree of adhesion is not as difficult to separate the general imagination, so the recurrent acoustic neuroma should not easily give up the opportunity for reoperation.