Holsinger F C, Coker N J, Jenkins H A
The Bobby R. Alford Department of Otorhinolaryngology and Communicative Sciences, Baylor College of Medicine Houston, Texas 77030, USA.
Am J Otol. 2000 Sep;21(5):695-700.
To evaluate preservation of hearing in the resection of vestibular schwannomas.
A retrospective case review.
Tertiary-care medical center.
Forty-seven patients (25 men, 22 women) were studied; mean age was 46 years, mean tumor diameter 9.8 mm (range 3-30 mm.)
All patients underwent resection of vestibular schwannomas by the middle cranial fossa (MCF) or the retrosigmoid (RS) approach.
Hearing preservation was classified by the criteria outlined by the American Academy of Otolaryngology-Head Neck Surgery. Hearing was assessed preoperatively and postoperatively at 1 month and 1 year. Facial function was graded according to the House-Brackmann scale. Minimum follow-up was 18 months.
Hearing was preserved in 69% of patients who underwent the MCF approach but in only 33% of patients for whom the RS approach was used. The RS approach was used for larger tumors (mean diameter 15 mm) and the MCF procedure for smaller tumors (mean diameter 9 mm). One hundred percent of patients had facial function H/B grade II or better, regardless of approach.
Hearing function can be reliably preserved in a high percentage of selected patients undergoing resection of vestibular schwannoma.
评估前庭神经鞘瘤切除术中听力的保留情况。
回顾性病例分析。
三级医疗中心。
共研究了47例患者（25例男性，22例女性）；平均年龄46岁，肿瘤平均直径9.8毫米（范围3 - 30毫米）。
所有患者均通过中颅窝（MCF）或乙状窦后（RS）入路进行前庭神经鞘瘤切除术。
听力保留情况根据美国耳鼻咽喉 - 头颈外科学会制定的标准进行分类。术前以及术后1个月和1年对听力进行评估。面部功能根据House - Brackmann量表进行分级。最短随访时间为18个月。
采用中颅窝入路的患者中，69%的患者听力得以保留，而采用乙状窦后入路的患者中只有33%的患者听力得到保留。乙状窦后入路用于较大的肿瘤（平均直径15毫米），中颅窝手术用于较小的肿瘤（平均直径9毫米）。无论采用何种入路，100%的患者面部功能为H/B二级或更好。
在接受前庭神经鞘瘤切除术的部分选定患者中，听力功能能够可靠地得到保留。
