CAJ | 학술논문

目的探讨在听神经瘤显微手术中的岩静脉保护的方法和临床意义.方法显微手术治疗听神经瘤147例,通过先行肿瘤内减压,再逐步分离肿瘤周边结构的方法,143例岩静脉术中保护良好,4例被电凝处理.结果岩静脉保护良好的143例术后没有发生小脑出血性梗塞,电凝处理岩静脉的4例中1例发生一过性广泛性小脑水肿,随访18个月能自理生活,但仍有走路步态不稳.发生小脑出血性梗塞并水肿3例,其中1例死亡,2例经后颅窝减压后恢复良好,其中1例随访33个月无明显神经功能障碍,1例随访12个月尚有走一字路不稳.结论在听神经瘤显微手术中,岩静脉可以被良好保护,一旦损伤需在手术后做好再次后颅窝减压手术的准备.
목적 탐토재은신경류현미수술중적암정맥보호적방법화림상의의.방법 현미수술치료은신경류147례,통과선행종류내감압,재축보분리종류주변결구적방법,143례암정맥술중보호량호,4례피전응처리.결과 암정맥보호량호적143례술후몰유발생소뇌출혈성경새,전응처리암정맥적4례중1례발생일과성엄범성소뇌수종,수방18개월능자리생활,단잉유주로보태불은.발생소뇌출혈성경새병수종3례,기중1례사망,2례경후로와감압후회복량호,기중1례수방33개월무명현신경공능장애,1례수방12개월상유주일자로불은.결론 재은신경류현미수술중,암정맥가이피량호보호,일단손상수재수술후주호재차후로와감압수술적준비.
Objective To discuss the preservation and clinical significance of petrosal vein in microsurgical operation of acoustic neuroma. Methods 147 patients with acoustic neuroma were operated, with internal decompression of the tumor firstly then dissected the tumor with surrounding structures, the petrosal vein were protected well in 143 cases and failed to protect in 4 cases. Results No hemorrhagic infarction in cerebellar was observed in 143 cases with intact petrosal vein. One case occurred with extensive cerebellar edema, which has gait disturbance after 18 months follow-up. The other three cases occurred with vein infarction and hemorrhagic edema after petrosal vein damage. One was dead and the other two were recovered well after decompression of posterior cranial fossa. One has no significant neurological deficit after 33 months follow-up, while the other has difficulty in line walking after 12 months follow-up. Conclusion Petrosal vein should be well protected in the operation of acoustic neuroma, the decompression of posterior cranial fossa should be considered if petrosal vein failed to protect.