听神经瘤患者术中面神经刺激阈与术后早期面神经功能的关系

The Relationship Between the Intraoperative Facial Nerve Stimulation Threshold and the Early Postoperative Facial Nerve Function after Acoustic Neuroma Resection

胡凌翔;吴皓;杨军;黄琦;汪照炎;吕静荣;张治华;马衍;

1:上海交通大学医学院附属新华医院耳鼻咽喉头颈外科

2:上海交通大学耳科学研究所

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摘要

目的探讨听神经瘤患者术中面神经监测动作电位阈值与术后早期面神经功能的关系,以期预测术后面神经功能。方法 122例听神经瘤患者均在全麻下行肿瘤完全切除后以NIM监护仪刺激脑干段面神经,记录引出面神经动作电位的最小毫安数即为面神经刺激阈。依据House-Brackmann(H-B)分级标准对术后2周患者的面神经功能进行评估,比较不同级别面神经功能患者术中面神经刺激阈。结果术后面神经功能I-II级组术中面神经刺激阈值为0.1±0.09mA,与III-IV级(0.26±0.27mA)、IV级(0.32±0.33mA)、V-VI级组(0.63±0.54mA)阈值比较差异有统计学意义(P<0.05);I-III级组(0.14±0.13mA)与IV级、V-VI级组比较差异也有统计学意义(P<0.05);术中面神经刺激刺激阈值小于0.1mA组术后面神经功能明显好于术中面神经刺激监测阈值0.1～0.2mA组和大于0.2mA组患者(P<0.05)。结论术中面神经阈值能有效地预测术后面神经功能,阈值小于0.1mA者提示术后面神经功能可能恢复良好。

关键词

听神经瘤;面神经;面神经监护

基金项目(Foundation):

国家自然科学基金(30801286,2009-2011)、(30973307,2010-2012);; 上海高校选拔培养优秀青年教师科研专项基金(jdy09130.2010-2011)资助

作者

胡凌翔;吴皓;杨军;黄琦;汪照炎;吕静荣;张治华;马衍;

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