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目的总结自１９８４年以来采用显微外科技术对大型、巨大型听神经瘤３８２例手术切除的体会，以提高此类肿瘤的手术治疗效果。方法采用显微外科技术，枕下乙状窦后小骨商经内听道入路，切除肿瘤，其中１３２例手术是在神经功能监护仪的监测下进行。结果肿瘤全切率为９５％，面神经保留率７３％；在神经功能监护仪的监测下，肿瘤全切率为１００％，面神经保留率为９８％，耳蜗神经保留率为４２％。自１９９０年以后无手术死亡。结论对于大型、巨大型听神经瘤，必须在手术显微镜下进行，磨除内听道后壁，切除内听道内的肿瘤，才能做到真正意义上的肿瘤全切。术中应用神经功能监护仪对面、耳蜗神经的辨认及保护尤为重要，并可估计术后面神经功能恢复的程度。
Objective To summarize the experience of surgical resection of 382 cases of large and giant acoustic neuroma using microsurgical technique since 1984 in order to improve the surgical treatment effect of such tumors. Methods The technique of microsurgery was used to excise the posterior segment of the posterior sigmoid sinus via the internal auditory canal, of which 132 cases were performed under the monitoring of neurological function monitor. Results The total resection rate was 95% and the facial nerve retention rate was 73%. The total resection rate was 100%, the facial nerve retention rate was 98% and the cochlear nerve retention rate was 42% under the monitoring of neurological function monitor. No surgery died since 1990. Conclusion For large, huge acoustic neuroma, it must be carried out under a surgical microscope, grinding the posterior wall of the auditory canal, resection of the tumor within the auditory canal, in order to achieve the true sense of the total tumor resection. Intraoperative application of neurological function monitor opposite, cochlear nerve identification and protection is particularly important, and can estimate the degree of facial nerve function recovery.