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目的 探讨显微手术切除大型听神经瘤的入路和方法。方法 经枕下入路显微手术切除大型听神经瘤33例。结果全切除29例,次全切除4例,无术后血肿、CSF漏及空气栓塞发生,无死亡;随访2月～4年,均能参加正常工作和学习,遗留永久性面瘫3例。结论 枕下乙状窦后入路显微手术是大型听神经瘤的最佳入路和方法,并能较好的保留听、面神经功能。手术应强调仔细、耐心操作。
Objective To investigate the approaches and methods of microsurgical removal of large acoustic neuromas. Methods 33 patients with large acoustic neuroma underwent microsurgery via suboccipital approach. Results Total resection in 29 cases, subtotal resection in 4 cases, no postoperative hematoma, CSF leakage and air embolism occurred, no death; followed up for 2 months to 4 years, can participate in normal work and study, leaving 3 cases of permanent facial paralysis. Conclusion Suboccipital retrosigmoid posterior approach microsurgery is the best approach and method for large acoustic neuroma, and can well preserve the function of hearing and facial nerve. Surgery should be emphasized carefully and patiently.