Jamróz Barbara, Niemczyk Kazimierz, Morawski Krzysztof, Bartoszewicz Robert
Katedra i Klinika Otolaryngologii Warszawski Uniwersytet Medyczny SP CSK Banacha 1a.
Otolaryngol Pol. 2010 Jun;64(7):3-9. doi: 10.1016/S0030-6657(10)70001-9.
The main tumor of cerebellopontine angle are vestibular schwannoma (80-90%). According to National Institute of Health Consensus Development Conference the best treatment method is microsurgery. There are three principal surgical approaches: translabyrinthin, retrosigmoid and middle fossa. Only the latter two approaches provide the possibility of hearing preservation.
Technique of surgery and postoperative morbidity after MFA.
39 patients (40 tumor) suffered from tumor of cerebellopontine angle, operated by using middle fossa approach in years 1998-2007. We evaluate hearing preservation and function of facial nerve and others postoperative morbidity.
22.5% of patients has hearing impairment and 32.5% has facial weakness. By individual cases we observed: CSF leak, meningitis, corneal ulceration, ischialgia, wound bleeding and venue thrombosis. 1/3 of patients suffered from headache and disequilibrium and 1/6 suffered from tinnitus.
According to NIH middle fossa approach is one of three possible approaches in microsurgery of cerebellopontine angle tumors. There is possible total tumor removal with hearing preservation. Monitoring of facial and cochlear nerve during operation is recommended.
桥小脑角的主要肿瘤是前庭神经鞘瘤（80 - 90%）。根据美国国立卫生研究院共识发展会议，最佳治疗方法是显微手术。有三种主要的手术入路：经迷路、乙状窦后和中颅窝。只有后两种入路提供了保留听力的可能性。
中颅窝入路手术技术及术后发病率。
1998 - 2007年，39例（40个肿瘤）桥小脑角肿瘤患者采用中颅窝入路进行手术。我们评估了听力保留情况、面神经功能及其他术后发病率。
22.5%的患者有听力障碍，32.5%的患者有面部无力。个别病例观察到：脑脊液漏、脑膜炎、角膜溃疡、坐骨神经痛、伤口出血和静脉血栓形成。1/3的患者有头痛和平衡失调，1/6的患者有耳鸣。
根据美国国立卫生研究院的标准，中颅窝入路是桥小脑角肿瘤显微手术三种可能的入路之一。有可能在保留听力的情况下完全切除肿瘤。建议术中监测面神经和蜗神经。
