Wiet R J, Teixido M, Liang J G
Department of Otolaryngology-Head and Neck Surgery, Northwestern University Medical School, Chicago, Illinois.
Otolaryngol Clin North Am. 1992 Apr;25(2):389-412.
There has been a continuous lowering of mortality and morbidity rates in the 20th century, thanks to increasing experience and newer technology. Despite this, the readership should be aware of the hazards involved in this challenging field. Complications occur, and their incidence, mechanism, management, and prevention have been outlined here so physicians performing these procedures will be better prepared to manage them. We have found that the occurrence of complications can be greatly reduced through a team approach using the combined talents of a neurotologist, neurosurgeon, and frequently an internist. It is apparent from this article that the morbidity of removing larger tumors is significantly greater than the morbidity of removing small tumors. The recent introduction of MRI to the diagnostic armamentarium of the neurotologist may permit earlier detection and a further reduction of morbidity and mortality rates. Only continued study of prevention of complications will assure the improved quality of our results for patients undergoing microsurgical removal of acoustic neuromas.
20世纪以来，由于经验的不断积累和新技术的出现，死亡率和发病率持续下降。尽管如此，读者应该意识到这一具有挑战性的领域所涉及的风险。并发症时有发生，本文已概述了其发生率、机制、处理方法及预防措施，以便实施这些手术的医生能更好地应对。我们发现，通过神经耳科医生、神经外科医生以及常常还包括内科医生的联合才能，采用团队协作的方法可大大降低并发症的发生率。从本文可以明显看出，切除较大肿瘤的发病率明显高于切除较小肿瘤的发病率。神经耳科医生的诊断手段中最近引入了磁共振成像（MRI），这可能有助于早期发现并进一步降低发病率和死亡率。只有持续研究并发症的预防，才能确保接受听神经瘤显微手术切除的患者获得更好的治疗效果。
