论文部分内容阅读
目的 :探讨巨大听神经瘤的显微外科解剖和手术技巧。方法 :对 32例巨大听神经瘤手术进行回顾性分析 ,重点分析肿瘤的血供来源、与颅神经及重要血管结构的解剖关系和全切除的显微外科技巧。结果 :肿瘤全切除率达10 0 %,面神经解剖保留 6 2 .5 %(2 0 / 32 ) ,无手术死亡。术中发现面听神经大多数 (75 .0 %)位于肿瘤前方 (前方中部46 .9%、前上方 2 8.1%) ,少数位于肿瘤的上极 (12 .5 %)或下极 (9.4%) ,仅发现 1例面听神经位于肿瘤后方 ,未见面神经穿过肿瘤者。滑车神经和三叉神经均位于肿瘤前上方或上极 ,而后组颅神经则位于肿瘤的下极或下外侧。肿瘤的血供来源主要为小脑后下动脉和小脑前下动脉的分支 ,少部分肿瘤小脑上动脉亦参与供血。结论 :掌握巨大听神经瘤的显微解剖和手术技巧对全切除该类肿瘤和颅神经功能保护具有重要意义。
Objective: To investigate the microsurgical anatomy and surgical techniques of giant acoustic neuroma. Methods: A retrospective analysis was performed on 32 cases of giant acoustic neuroma surgery. The focus was on analysis of tumor blood supply, anatomy of the cranial nerves and important vascular structures, and total removal of microsurgical techniques. Results: The total resection rate was 100%. Facial nerve anatomy retained 62.5% (20/32) with no surgical death. The majority (75.0%) of the facial nerve were found in front of the tumor (46.9% in the anterior middle and 8.11% in the anterior front), and a few were located in the upper pole (12.5%) or lower pole (9.4%) of the tumor. , Only found in 1 case of facial nerve located in the rear of the tumor, no facial nerve through the tumor. Both the trochlear nerve and the trigeminal nerve are located on the anterior or anterior pole of the tumor, while the cranial nerves of the posterior group are located on the inferior pole or lateral of the tumor. The main source of blood supply for the tumor is the posterior inferior cerebellar artery and the branch of the anterior inferior cerebellar artery, a small part of the upper cerebellar artery also involved in blood supply. CONCLUSIONS: To master the microsurgical anatomy and surgical techniques of giant acoustic neuroma is of great importance in the total excision of such tumors and the functional protection of cranial nerves.