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近年来,听神经瘤切除术均由颅后窝、迷路和颅中窝三途径进入手术。各途径均有其优缺点。经内耳道听神经瘤切除(DiTullio等),易识别面神经内耳道段。颅后窝进入,可早期定位面神经。颅后窝和经迷路联合进路(Glasscock)则能保留乙状窦,且可较好地暴露脑干,适于大听神经瘤切除。颅中窝进入用于内耳道内的小听神经瘤,术后可能保存听力。作者自1978至1980年间,取半坐位经颅后窝进路先后进行了74例听神经瘤切除术。无一例死亡,并发症亦少。其中脑脊液耳、鼻漏7例。脑膜炎3例和术后出血2例。术后无脑干梗塞形成。74例患者中,73例均一次手术切除肿瘤。1
In recent years, acoustic neuroma resection has been performed by the three approaches of posterior fossa, labyrinth and cranial fossa. Each approach has its advantages and disadvantages. Through the removal of acoustic neuroma of the inner ear (DiTullio et al.), it is easy to identify the facial nerve inner ear. After the cranial fossa enters, the facial nerve can be positioned early. The posterior cranial fossa and the Glasscock approach retain the sigmoid sinus, and can better expose the brainstem and is suitable for the removal of large acoustic neuromas. The middle cranial fossa enters into small acoustic neuromas used in the internal auditory canal and may preserve hearing after surgery. From 1978 to 1980, the author performed 74 cases of acoustic neuroma resection in a semi-seat transcranial posterior fossa approach. No death occurred and there were fewer complications. Among them, 7 cases had cerebrospinal fluid ear and rhinorrhea. 3 cases of meningitis and 2 cases of postoperative bleeding. Postoperative brain stem infarction was not formed. Of the 74 patients, 73 were all surgically resected. 1