Xing Hong-Shun, Wang Shou-Xian, Wang Zhe, Cao Pei-Cheng, Ma Yong-Qian, Wang Zeng-Wu
Department of Neurosurgery, People's Hospital of Weifang, Guangwen Street 151#, Weifang, 261041, Shandong, China.
Cell Biochem Biophys. 2015 May;72(1):73-6. doi: 10.1007/s12013-014-0406-6.
The objective of this study was to summarize the experience about the protection of the facial nerve in surgery for acoustic neuroma surgery with the aim to improve the retention of facial nerve function and the quality of life. Forty-two patients with acoustic neuroma were recruited from the year 2010 to 2013. Using microsurgical techniques, the tumors were resected through the suboccipital approach over the posterior edge of the sigmoid sinus, and intraoperative electrophysiological monitoring of the facial nerve function was performed. The House-Brackmann (H-B) grading was used to evaluate the facial nerve function evaluation postoperatively. Total tumor resection was achieved in 32 cases, and partial resection in 10 cases, without any intraoperative deaths. Also facial nerves were retained in 35 of 42 cases (83.33 %). One week after surgery, the facial nerve H-B grading was grade I in 8 cases, grade II in 15 cases, grade III in 12 cases, grade IV in 6 cases, and grade V in 1 case. The key to improved protection of the facial nerve during acoustic neuroma surgery includes a complete understanding of the anatomy of the cerebellopontine angle, proper use of microsurgical techniques, and intraoperative electrophysiological monitoring of the status of facial nerve functions to avoid damage to the nerves.
本研究的目的是总结听神经瘤手术中面神经保护的经验，以提高面神经功能保留率和生活质量。2010年至2013年招募了42例听神经瘤患者。采用显微外科技术，经乙状窦后缘枕下入路切除肿瘤，并对面神经功能进行术中电生理监测。采用House-Brackmann（H-B）分级法评估术后面神经功能。32例实现肿瘤全切，10例次全切除，无术中死亡病例。42例中有35例（83.33%）保留了面神经。术后1周，面神经H-B分级为Ⅰ级8例，Ⅱ级15例，Ⅲ级12例，Ⅳ级6例，Ⅴ级1例。听神经瘤手术中提高面神经保护的关键包括全面了解桥小脑角的解剖结构、正确使用显微外科技术以及术中对面神经功能状态进行电生理监测以避免损伤神经。
