CAJ | 학술논문

目的探讨2型神经纤维瘤病(NF2)前庭神经鞘瘤的显微外科治疗策略和疗效评价.方法回顾性分析了90例NF2患者的病例资料、影像学及听力学表现,手术均采用枕下乙状窦后入路切除前庭神经鞘瘤,术中采用面神经、三叉神经和听性脑干反应(ABR)监测.结果肿瘤全切除78例,近全切除9例,次全切除3例,未全切病例66.7％ (8/12)为患者唯一存在听力耳;面神经解剖保留85例,面神经功能H-B分级Ⅰ～Ⅲ级57例;按AAO-HNS分级标准,B组患者20例,C组12例,D组58例.结论显微外科手术是治疗NF2前庭神经鞘瘤的有效方法,肿瘤切除时应尽可能保留神经功能,提高患者长期生存质量.
목적 탐토2형신경섬유류병(NF2)전정신경초류적현미외과치료책략화료효평개.방법 회고성분석료90례NF2환자적병례자료、영상학급은역학표현,수술균채용침하을상두후입로절제전정신경초류,술중채용면신경、삼차신경화은성뇌간반응(ABR)감측.결과 종류전절제78례,근전절제9례,차전절제3례,미전절병례66.7％ (8/12)위환자유일존재은력이;면신경해부보류85례,면신경공능H-B분급Ⅰ～Ⅲ급57례;안AAO-HNS분급표준,B조환자20례,C조12례,D조58례.결론 현미외과수술시치료NF2전정신경초류적유효방법,종류절제시응진가능보류신경공능,제고환자장기생존질량.
Objective To study surgical treatment strategies and outcomes of bilateral vestibular schwannomas(VS) in neurofibromatosis (NF)type 2 patients.Methods Retrospective study 90 cases of clinical information,imaging and of neurofibromatosis type 2 patients.Suboccipital approach was taken for 90 cases of VS resection and intraoperative monitoring of the facial and trigeminal nerves and auditory brainstem responses (ABR) was used in all cases.Results Total tumor resection was achieved in 78 cases.Near total and sub-total resection were be done in 9 and 3 cases,as 8 of 12 was the only hearing ear.As more than 1-year follow-up,the anatomical integrity of the facial nerve was preserved in 85 cases.59 cases had Ⅰ-Ⅲ grade of H-B Score.Postoperative hearing level Analysis according to AAO-HNS grade showed that hearing was preserved in 20 of 90 cases for Class B,12 cases for Class C and in 58 cases for Class D.Conclusion Vestibular schwannomas in NF2 can be successfully treated with microsurgical treatment.Neurological function should be presevered as good as possible for the patients's quality of life.