Lang J, Gordon D S, Kerr A G, Smyth G D
Ulster Med J. 1988 Oct;57(2):141-8.
Forty acoustic neuromas have been removed surgically between 1976 and 1986. The condition was unilateral in 32 and bilateral in four. There were 31 large, four medium and five small tumours. Excision was complete in 16 and incomplete in 24. Of the incomplete removals 14 were subtotal leaving microscopic remnants, eight were partial capsular and two were intracapsular. Follow-up ranged from two months to ten years (median 3.5 years).There was one early death in an 83-year-old. The overall incidence of post-operative complete facial paralysis was 20% but reached 55% for large tumours when excision was complete. Twenty-eight patients had hearing before operation and in eleven patients some preservation of hearing was possible (39%). In these, the excision was complete in three, subtotal in four, partial capsular in three and intracapsular in one.Of the unilateral tumours, there have been three recurrences requiring repeat surgery. All were initially incompletely excised. Two were of an invasive nature causing considerable erosion of the petrous temporal bone making complete excision impossible. For the bilateral tumours a deliberate incomplete excision was first performed on one side to ensure preservation of hearing. Further excision on this side was then left until such time as hearing was lost. Complications included CSF otorhinorrhoea (5%), persistent but temporary nausea and vomiting (10%), meningitis (5%), facial numbness (5%) and hoarseness and dysphagia (3%).
1976年至1986年间，共通过手术切除了40例听神经瘤。其中32例为单侧，4例为双侧。有31例大肿瘤、4例中等肿瘤和5例小肿瘤。16例完全切除，24例不完全切除。在不完全切除的病例中，14例为次全切除，残留显微镜下可见的肿瘤组织；8例为部分包膜切除；2例为包膜内切除。随访时间从2个月至10年不等（中位时间为3.5年）。一名83岁患者术后早期死亡。术后完全性面瘫的总体发生率为20%，但对于大肿瘤，完全切除时发生率达到55%。28例患者术前有听力，其中11例患者有可能保留部分听力（39%）。在这些患者中，3例完全切除，4例次全切除，3例部分包膜切除，1例包膜内切除。在单侧肿瘤中，有3例复发需要再次手术。所有这些病例最初均为不完全切除。2例具有侵袭性，导致颞骨岩部严重侵蚀，无法完全切除。对于双侧肿瘤，先对一侧进行有意的不完全切除以确保保留听力。然后等待该侧听力丧失后再进行进一步切除。并发症包括脑脊液耳鼻漏（5%）、持续性但暂时性恶心和呕吐（10%）、脑膜炎（5%）、面部麻木（5%）以及声音嘶哑和吞咽困难（3%）。
