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目的探讨经枕下乙状窦后入路显微手术治疗大型听神经瘤的操作技巧及治疗效果。方法将全部的45例患者都采用枕下乙状窦后入路,显微手术切除肿瘤,14例采用内镜辅助下切除。结果本组45例中,全切除40例,次全切5例,肿瘤全切除率88.9%;面神经功能保留33例。术后听力减退或加重9例,出现面部麻木6例,面瘫l1例,经随访6个月～2年,听力减退恢复6例,面部麻木恢复4例,面瘫恢复7例。结论经枕下乙状窦后入路显微手术切除大型听神经瘤,对面神经可获得解剖学与功能的保护,能明显降低并发症与病死率。
Objective To investigate the operative technique and therapeutic effect of microsurgical treatment of large acoustic neuroma via suboccipital sigmoid sinus posterior approach. Methods All 45 patients underwent suboccipital sigmoid sinus surgery, microsurgery to remove the tumor, and 14 patients underwent endoscopic assisted resection. Results The group of 45 cases, 40 cases of total resection, subtotal resection in 5 cases, tumor resection rate of 88.9%; facial nerve function in 33 cases. Postoperative hearing loss or aggravation in 9 cases, facial numbness in 6 cases, facial paralysis l1 cases, followed up for 6 months to 2 years, 6 cases of hearing loss recovery, facial numbness recovery in 4 cases, facial paralysis recovery in 7 cases. Conclusions Microsurgery of the suboccipitated sigmoid sinus resection of large acoustic neuromas can provide anatomical and functional protection of the facial nerve and can significantly reduce complications and mortality.