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目的探讨显微手术切除大型听神经瘤的入路和方法。方法经枕下入路显微手术切除大型听神经瘤65例,其中锁孔手术10例。结果全切除58例,次全切除7例,无死亡,出现术后血肿1例。随访2个月～5年,均参加正常工作和学习,遗留永久性面瘫5例。结论枕下入路显微手术是大型听神经瘤的最佳入路和方法之一,能较好地保留听、面神经功能。锁孔手术完全可以达到切除大型听神经瘤要求。
Objective To investigate the approaches and methods of microsurgical removal of large acoustic neuromas. Methods Sixty-five patients with large acoustic neuroma underwent microsurgery via suboccipital approach, including 10 keyhole surgery. Results Total resection in 58 cases, subtotal resection in 7 cases, no death, postoperative hematoma in 1 case. Follow-up 2 months to 5 years, both to participate in normal work and study, leaving 5 cases of permanent facial paralysis. Conclusions Microsurgery of suboccipital approach is one of the best approaches and methods for large acoustic neuroma, which can well preserve the function of hearing and facial nerve. Keyhole surgery can achieve the full removal of large acoustic neuroma requirements.