中国医药指南
中國醫藥指南
중국의약지남
CHINA MEDICINE GUIDE
2014年
22期
253-254
,共2页
听神经瘤%显微手术%伽玛刀
聽神經瘤%顯微手術%伽瑪刀
은신경류%현미수술%가마도
Acoustic neuroma%Microsurgery%Gamma knife
目的：探讨伽玛刀治疗听神经瘤失败后再行手术治疗的方法及其效果。方法20例听神经瘤患者接受伽玛刀治疗后不同时期复查MRI发现肿瘤继续生长或临床症状加重，采用枕下乙状窦后入路行听神经瘤切除术。结果术中发现肿瘤与面神经及周围结构粘连明显。肿瘤全切及近全切除共18例（占90%），次全切除共2例（占10%）。面神经解剖保留18例（占90%），功能保留16例（占80%）。结论采用枕下乙状窦后入路肿瘤切除术是挽救伽玛刀治疗听神经瘤失败后的有效方法，面神经功能保护满意。
目的：探討伽瑪刀治療聽神經瘤失敗後再行手術治療的方法及其效果。方法20例聽神經瘤患者接受伽瑪刀治療後不同時期複查MRI髮現腫瘤繼續生長或臨床癥狀加重，採用枕下乙狀竇後入路行聽神經瘤切除術。結果術中髮現腫瘤與麵神經及週圍結構粘連明顯。腫瘤全切及近全切除共18例（佔90%），次全切除共2例（佔10%）。麵神經解剖保留18例（佔90%），功能保留16例（佔80%）。結論採用枕下乙狀竇後入路腫瘤切除術是輓救伽瑪刀治療聽神經瘤失敗後的有效方法，麵神經功能保護滿意。
목적：탐토가마도치료은신경류실패후재행수술치료적방법급기효과。방법20례은신경류환자접수가마도치료후불동시기복사MRI발현종류계속생장혹림상증상가중，채용침하을상두후입로행은신경류절제술。결과술중발현종류여면신경급주위결구점련명현。종류전절급근전절제공18례（점90%），차전절제공2례（점10%）。면신경해부보류18례（점90%），공능보류16례（점80%）。결론채용침하을상두후입로종류절제술시만구가마도치료은신경류실패후적유효방법，면신경공능보호만의。
Objective To investigate the microsurgery method and effect of recurrence acoustic neuromas after gamma knife treatment. Method 20 patients with tumor recurrence after treated with gamma knife. The sub-occipital retrosigmoid approaches were used in all patients to removal the tumors. Results The tumors were adherent to facial nerve and brainstem evidently. Total or near total tumor resection was achieved in 18 cases(90%), and sub-total resection in 10 cases (10%). The anatomical integrity of the facial nerve was preserved in 90%of the cases. At last follow-up, 80%of all patients had excellent or good facial nerve function. Conclusion Acoustic neuromas treated with gamma knife might recurrence with different interval. Trans-labyrinthine removal could be an effective salvage surgery, and the postoperative facial nerve function is satisfactory.
