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目的探讨神经电生理监测在桥小脑角肿瘤术中的意义。方法对2009年8月至2012年3月山西医科大学第一医院神经外科46例桥小脑角肿瘤患者进行术中神经电生理监测,随访并观察术后颅神经功能。结果肿瘤全切38例(82.6%),近全切6例(13.0%),次全切2例(4.3%)。面神经解剖保留43例(93.5%),面神经功能House-Brackmann分级Ⅰ～Ⅱ级32例(69.6%)。术后无脑干功能障碍及死亡病例。结论在桥小脑角区肿瘤显微切除术中使用联合电生理监测方法,可减少术中对颅神经及脑干等正常组织结构的损伤,增加手术安全性。此外,术末刺激强度可有效帮助判断神经功能的预后。
Objective To investigate the significance of neuroelectrophysiological monitoring in the treatment of cerebellopontine angle tumor. Methods From August 2009 to March 2012, 46 patients with cerebellopontine angle tumor of neurosurgery in the First Hospital of Shanxi Medical University underwent neuroelectrophysiology monitoring and follow-up. The function of cranial nerves after operation was observed. Results The tumors were completely resected in 38 cases (82.6%), nearly complete resection in 6 cases (13.0%) and subtotal resection in 2 cases (4.3%). Facial nerve anatomy retained 43 cases (93.5%), facial nerve function House-Brackmann grade Ⅰ ~ Ⅱ 32 cases (69.6%). No postoperative brain stem dysfunction and deaths. Conclusion The combination of electrophysiological monitoring method in the microsurgical resection of cerebellopontine angle can reduce the intraoperative damage to the normal tissue such as the cranial nerves and brain stem and increase the safety of the operation. In addition, the intensity of postoperative stimulation can be helpful in judging the prognosis of neurological function.