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目的 :了解面神经监测的方法学以及术中监测时的电刺激强度和面神经预后的关系 ,在实现解剖保留面神经的基础上 ,分析影响面神经预后的因素。方法 :报告了 130例听神经瘤 ,12 9例采用枕下乙状窦后入路 ,1例采用经迷路入路。术中使用Viking IV型多导术中监测仪 ,监测自发和诱发面肌肌电图。结果 :通过术中监测自发EMG结合单极恒压电刺激诱发EMG可以精确判断面神经的位置 ,面神经解剖率为 94 6 1%。刺激量由大到小 ,距离由远及近 ,可以准确定位面神经。结论 :长期随访发现诱发面肌肌电图的刺激强度与面神经功能呈负相关 ,阈刺激或接近阈刺激可诱发出肌电图者面神经功能恢复理想。
OBJECTIVE: To understand the methodology of facial nerve monitoring and the relationship between electrical stimulation intensity and facial nerve prognosis during intraoperative monitoring, and to analyze the factors influencing the prognosis of facial nerve on the basis of anatomical preservation of facial nerve. Methods: 130 cases of acoustic neuroma were reported, 129 cases of suboccipital sigmoid sinus posterior approach, and 1 case of labyrinthine approach. Intraoperative use of Viking IV type of multi-guided intraoperative monitoring, monitoring of spontaneous and induced facial muscle EMG. Results: The location of facial nerve can be accurately determined by intraoperative monitoring of spontaneous EMG combined with unipolar constant voltage electrical stimulation. Facial nerve anatomy was 94 6 1%. Stimulus volume from large to small, from the distance and near, you can accurately locate the facial nerve. CONCLUSION: The long-term follow-up found that the intensity of EMG stimulation induced by facial muscles was negatively correlated with facial nerve function. The facial nerve function recovery induced by threshold stimulation or near-threshold stimulation was ideal.