临床神经外科杂志2019，Vol.16Issue(4)：320-325,6.DOI:10.3969/j.issn.1672-7770.2019.04.009
大型听神经瘤手术中面神经的保护研究
Facial nerve reservation in large acoustic neuroma surgery
摘要
Abstract
To explore the techniques and methods of facial nerve function preservation during microsurgery resection of large acoustic neuromas.Methods The clinical data of 48 patients with large acoustic neuromas treated microsurgically by suboccipital retrosigrnoid transmeatus approach under neurophysiological monitoring assistance in the First Affiliated Hospital of Xiamen University from March 2011 to February 2018 were analyzed retrospectively.The postoperative effects and the facial nerve function were observed and followed up.Results Total resection was achieved in 31patients(64.6%), subtotal in 11(22.9%) and partial in 6(12.5%). Facial nerve anatomical preserved were achieved in all patients.One week after tumor resection , the functional valuation of facial nerve according to postoperative House-Brackmann scale showed 20 patients(41.67%) in grades Ⅰ-Ⅱ, 27 patients (56.25%) in grades Ⅲ-Ⅳ, and 1 patient (2.08%) in grades Ⅳ-Ⅵ.Three months after tumor resection, the functional valuation of facial nerve showed 21 patients(43.75%) in grades Ⅰ-Ⅱ, 27 patients(56.25%) in grades Ⅲ-Ⅳ. Long-term facial nerve outcome depended on the size of the tumor.The increase of tumor size indicated worse prognosis of postoperative facial nerve function ( all P ＜0.05 ).Conclusions Meticulous microsurgical operation and consummate neurophysiological monitoring assistance are of great value for intraoperative facial nerve preservation.Preoperative tumor size can be used as a predictor of postoperative facial nerve function prognosis.关键词
大型听神经瘤/面神经/神经电生理监测/肿瘤体积Key words
large acoustic neuroma/facial nerve/neurophysiological monitoring /tumor size分类
医药卫生引用本文复制引用
陈曦,蒋伟超,孙金莉,朱治,陈四方,谭国伟,王占祥..大型听神经瘤手术中面神经的保护研究[J].临床神经外科杂志,2019,16(4):320-325,6.基金项目
福建省科技计划项目(2013D022) （2013D022）
福建省卫生计生委青年科研课题项目(2017-2-100) （2017-2-100）
福建省自然科学基金计划项目(2018J01376) （2018J01376）
