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目的探讨在术中神经电生理监测下经枕下-乙状窦后入路显微手术切除大型听神经瘤的方法及效果。方法回顾性分析2013年1月至2015年10月收治的85例大型听神经瘤的临床资料,均在术中神经电生理监测下,采取直切口乙状窦后入路小骨窗显微手术切除肿瘤。结果肿瘤全切除76例(89.4%),次全切除9例(10.6%);术中面神经解剖保留80例(94.1%)。术后即刻、7 d、3个月、6个月、9个月、1年面神经功能分级优良率(H-B分级Ⅰ~Ⅱ级)分别为88.2%、56.0%、41.9%、50.9%、68.6%、86.7%。结论在术中神经电生理监测下显微手术治疗大型听神经瘤,可更好保护面神经功能,提高术后生活质量。
Objective To investigate the method and effect of microsurgical removal of large acoustic neuroma via suboccipital-sigmoid sinus surgery under electrophysiological monitoring during operation. Methods The clinical data of 85 patients with large acoustic neuroma treated in our hospital from January 2013 to October 2015 were retrospectively analyzed. All the patients underwent microsurgical removal of the small incision of the sigmoid sinus using direct incision . Results Totally 76 cases (89.4%) underwent total resection and 9 cases (10.6%) underwent total subtotal resection. There were 80 cases (94.1%) of intraoperative anatomy of the facial nerve. The rate of facial nerve function grading (HB grade Ⅰ ~ Ⅱ grade) at postoperative day was 88.2%, 56.0%, 41.9%, 50.9% and 68.6% at 7 d, 3 months, 6 months, 9 months and 1 year respectively. , 86.7%. Conclusions Under the electrophysiological monitoring of intraoperative neurosurgery, microsurgical treatment of large acoustic neuroma can better protect facial nerve function and improve postoperative quality of life.