中国全科医学2017，Vol.20Issue(29)：3699-3702,4.DOI:10.3969/j.issn.1007-9572.2017.07.y21
全程面神经监测在听神经瘤术中面神经保护的应用研究
Facial Nerve Monitoring for the Protection of Facial Nerve during the Acoustic Neuroma Surgery
摘要
Abstract
Objective To investigate the effect of facial nerve monitoring by preoperative facial nerve imaging (FNI) via diffusion tensor imaging (DTI),combined with intraoperative electrophysiologic facial nerve monitoring for the protection of facial nerve during the acoustic neuroma surgery.Methods The enrolled participants were 11 consecutive cases of acoustic neuroma who received treatment in Ganzhou Hospital Affiliated to Nanchang University from January 2016 to January 2017.All of them underwent DTI for examining the ubiety between the facial nerve and acoustic neuroma preoperatively,and facial nerve dynamic electromyography (ECG) and electrical stimulation-evoked facial nerve EMG intraoperatively.The position of the facial nerve detected by DTI was tested during the surgery.And the function of the facial nerve was assessed postoperatively.Results By using DTI,it was found that,the facial nerve of all the cases was at the ventral side of the acoustic neuroma,specifically,it was at the middle part of the acoustic neuroma in 7 cases,at the lower part in 2 cases and at the upper part in 2 cases,all these were the same as those found in the surgery.Ten cases achieved total resection,but 1 case had internal auditory canal tumor residues.Intraoperative facial nerve dynamic EMG monitoring indicated the facial nerve and it's position.The facial nerve of all the patients were anatomically preserved in the surgery with a preservation rate of 100％.The results of 1-12-month follow-up showed that,there were 4 cases of House-Brackmann grade Ⅰ,6 cases of grade Ⅱ and 1 case of grade Ⅲ.Conclusion Preoperative FNI via DTI combined with intraoperative electrophysiologic facial nerve monitoring are helpful to locate and protect the facial nerve during surgery,and improve the anatomical and functional preservation rates of the facial nerve in acoustic neuroma surgery.关键词
神经瘤,听/面神经/弥散磁共振成像/电生理学监测Key words
Neuroma, acoustic/Facial nerve/Diffusion magnetic resonance imaging/Electrophysiologic monitoring分类
医药卫生引用本文复制引用
宋海民,吴至武,冯开明,罗德芳,蒋秋华..全程面神经监测在听神经瘤术中面神经保护的应用研究[J].中国全科医学,2017,20(29):3699-3702,4.基金项目
江西省科技厅重点研发计划项目(20161BBG70025) （20161BBG70025）
