经扩大迷路径路显微手术切除大型听神经瘤

Expanding Translabyrinthine Approach Microsurgery Resection of Large Acoustic Neuroma

顾兴智;尤乐都斯·克尤木;吴皓;

1:新疆维吾尔自治区人民医院耳鼻咽喉二科

2:上海交通大学医学院附属新华医院耳鼻咽喉头颈外科

摘要
目的探讨经扩大迷路径路大型听神经瘤切除术的显微手术技巧及效果。方法回顾性分析2013年14月收治的4例大型听神经瘤患者的临床资料,所有患者均采用扩大迷路径路显微手术治疗,术中面神经解剖保留3例,1例患者行面神经端端吻合。术后随访64月收治的4例大型听神经瘤患者的临床资料,所有患者均采用扩大迷路径路显微手术治疗,术中面神经解剖保留3例,1例患者行面神经端端吻合。术后随访610个月。结果本组4例大型听神经瘤患者肿瘤直径均≥5cm,最大为8cm,3例为重度感音神经性聋,1例高频听力下降;伴失明1例。术后复查内听道MRI显示肿瘤均全部切除,术后6个月随访时,2例面神经功能正常,1例患者面神经功能由Ⅲ级恢复到Ⅱ级,1例行面神经吻合的患者面神经功能由Ⅵ级恢复到Ⅳ级,1例伴失明的患者视力完全恢复正常。结论扩大迷路径路显微外科手术可以完全切除大型听神经瘤,并可部分或全部保留面神经功能。
关键词
听神经瘤;面神经;桥小脑角;并发症
基金项目(Foundation):
作者
顾兴智;尤乐都斯·克尤木;吴皓;
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