CAJ | 학술논문

目的探讨大型听神经瘤的诊断、经枕下-乙状窦后入路显微手术切除及预后价值.方法采用CT 或 MRI扫描检查和显微外科技术,作者对316例大型听神经瘤行系列手术切除.术中及术后评估面神经的功能.结果本组肿瘤255例(86.4%)达到全切除,43例(13.6%) 获次全切除.术后5例(1.6%)死亡,面神经的解剖学保留率为78.8%(249例).根据House-Brachman面神经分级标准,对258例进行1年的随访评估,面神经功能获得满意恢复者(I～IV级)为225例(87.2%).结论采用显微技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,并发症与死亡率很低, 临床疗效满意.
목적탐토대형은신경류적진단、경침하-을상두후입로현미수술절제급예후개치.방법채용CT 혹 MRI소묘검사화현미외과기술,작자대316례대형은신경류행계렬수술절제.술중급술후평고면신경적공능.결과본조종류255례(86.4%)체도전절제,43례(13.6%) 획차전절제.술후5례(1.6%)사망,면신경적해부학보류솔위78.8%(249례).근거House-Brachman면신경분급표준,대258례진행1년적수방평고,면신경공능획득만의회복자(I～IV급)위225례(87.2%).결론채용현미기술절제대형은신경류,대면신경가획득해부학여공능적보호,병발증여사망솔흔저, 림상료효만의.
Objective To evaluate the effect of diagnosis, microsurgical resection, and prognosis of the large acoustic neuromas (LANs) via a suboccipital retrosigmoid approach.Methods Using the CT or MRI scanning and microsurgical techniques, the authors conducted a series of surgeries for 316 cases of patients with LANs. The intraoperative and postoperative facial nerve function was evaluated.Results Total tumor removal was accomplished in 255 cases (86.4%) and subtotal tumor removal in 43 cases (13.6%) in this series. There were 5 cases (1.6%) of death after surgery. The facial nerve was preserved anatomically in 249 (78.8%) of the patients. According to the House-Brachman facial nerve grading system, acceptable function (grade I～ IV) were obtained in 87.2% (225/258 cases) by the time of follow-up assessment one year later.Conclusion Use of the microsurgical techniques for removing the LANs resulted in good anatomical and functional preservation of the facial nerve, with minimum incidence of morbidity and low mortality, and its clinical effect is satisfactory.