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[前庭神经鞘瘤切除及同期人工耳蜗植入术中蜗神经的神经监测。德文版]

[Neuromonitoring of the cochlear nerve during vestibular schwannoma resection and simultaneous cochlear implantation. German version].

作者信息

Weiss Nora M, Großmann Wilma, Schraven Sebastian, Oberhoffner Tobias, Mlynski Robert

机构信息

Klinik für Hals-Nasen-Ohrenheilkunde, Kopf- und Halschirurgie "Otto Körner", Universitätsmedizin Rostock, Doberaner Straße 137-139, 18057, Rostock, Deutschland.

出版信息

HNO. 2021 Dec;69(12):1002-1008. doi: 10.1007/s00106-021-00996-4. Epub 2021 Mar 17.

Abstract

Vestibular schwannomas (VS) are benign tumors that originate from the nerve sheath of one of the two vestibular nerves. VS can have a severe impact on everyday life of the patient and may lead to symptoms such as vertigo, hearing loss (e.g., as sudden deafness), deafness, and tinnitus. Treatment concepts include observational waiting with regular imaging control ("wait and scan"), radiotherapy, or surgical resection. Depending on the size of the tumor and status of functional hearing, the surgical approach may be retrosigmoidal, transtemporal, retrolabyrinthine, or translabyrinthine. The translabyrinthine approach always results in complete deafness due to opening of the bony labyrinth. If the nerve structure of the cochlear nerve is preserved, hearing rehabilitation with a cochlear implant (CI) may be successful. In this article the surgical technique for microsurgical resection of VS using a translabyrinthine approach with simultaneous cochlear implantation under intraoperative monitoring of the cochlear nerve by electrical stimulation is presented.

摘要

前庭神经鞘瘤(VS)是起源于两条前庭神经之一神经鞘的良性肿瘤。VS会对患者的日常生活产生严重影响,并可能导致眩晕、听力损失(如突发性耳聋)、耳聋和耳鸣等症状。治疗方案包括定期影像学检查下的观察等待(“观察与扫描”)、放射治疗或手术切除。根据肿瘤大小和功能性听力状况,手术入路可能为乙状窦后入路、颞下入路、迷路后入路或经迷路入路。经迷路入路由于打开了骨迷路,总会导致完全性耳聋。如果保留了蜗神经的神经结构,使用人工耳蜗(CI)进行听力康复可能会成功。本文介绍了在蜗神经电刺激术中监测下,采用经迷路入路同时植入人工耳蜗进行VS显微手术切除的手术技术。

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