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目的 探讨和分析中、大型听神经瘤手术面神经保留技术。方法 135例听神经瘤病人 ,采用枕下开颅乙状窦后经内听道入路 ,显微外科切除肿瘤。在面神经监护下 ,观察肿瘤与面神经的病理解剖关系 ,术后随访时间 4个月至 3年。结果 肿瘤全切除 12 5例 (93% ) ,近全切 4例(2 9% ) ,次全切 6例 (4 4% )。面神经解剖保留 12 2例 (90 % ) ,13例 (9% )解剖未能保留面神经。结论 术中首先识别不与肿瘤粘连的面神经脑干端及内听道端 ,再从两端沿面神经锐性分离肿瘤 ,是面神经解剖保留的技术关键
Objective To investigate and analyze the technique of preserving facial nerve in middle and large acoustic neuroma. Methods One hundred and thirty-five patients with acoustic neuroma were treated by intraocular stenosis after suboccipitating the sigmoid sinus, and tumors were removed by microsurgery. Under facial nerve monitoring, observe the pathological anatomy of the tumor and facial nerve, postoperative follow-up time of 4 months to 3 years. Results Totally 125 cases (93%) had complete resection, 4 cases (29%) underwent complete resection and 6 cases (44%) underwent total resection. Facial nerve anatomy retained 122 cases (90%), and 13 cases (9%) failed to retain the facial nerve. Conclusions The intraoperative identification of the facial nerve trunk and the internal auditory canal of the facial nerve that do not adhere to the tumor and the sharp separation of the tumor along the facial nerve from both ends are the key techniques of facial nerve anatomic retention