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目的:观察耳内镜辅助下听神经瘤切除术的疗效及并发症。方法:在硬管耳内镜辅助下采用迷路进路及乙状窦后进路行听神经瘤手术11例。结果:肿瘤全切除9例(81.8%),2例(18.2%)残留部分囊壁;术中内镜下探查面神经均完整,其中9例(81.8%)术后无面瘫表现,2例(18.2%)术后出现轻度周围性面瘫;术中内镜下探查蜗神经均完整,2例(18.2%)术后听力与术前比较保持不变,9例(81.8%)出现不同程度听力下降,其中,中度感音神经性聋1例,中重度2例,重度3例,极重度3例。结论:听神经瘤切除术中使用耳内镜可提高血管、神经保全率及肿瘤全切率,但也有其不足,仅能作为显微镜手术的辅助手段。
Objective: To observe the efficacy and complications of acoustic neuroma resection assisted by endoscope. Methods: 11 cases of acoustic neuroma were treated with labyrinthine approach and sigmoid sinus retrograde approach with the help of hard tube endoscope. Results: Nine cases (81.8%) had tumor resection and 2 cases (18.2%) had residual wall. The endoscopic examination of facial nerve was complete in 9 cases (81.8%), and no facial paralysis in 2 cases (18.2% %) Showed mild peripheral facial paralysis after operation. Endoscopic exploration of the cochlear nerve was complete in all cases. The hearing of 2 patients (18.2%) remained unchanged after operation, and 9 (81.8%) had varying degrees of hearing loss Among them, 1 patient had moderate sensorineural deafness, 2 moderate or severe, 3 severe and 3 extremely severe. Conclusion: The use of ear endoscopy in acoustic neuroma resection can improve the rate of blood vessel and nerve preservation and the rate of tumor resection, but it also has its shortcomings and can only be used as an auxiliary method for microsurgery.