Tayebi Meybodi Ali, Jyung Robert W, Liu James K
Departments of Neurological Surgery and.
Otolaryngology-Head and Neck Surgery.
Neurosurg Focus Video. 2021 Oct 1;5(2):V7. doi: 10.3171/2021.7.FOCVID21128. eCollection 2021 Oct.
In this illustrative video, the authors demonstrate retrosigmoid resection of a giant cystic vestibular schwannoma using the subperineural dissection technique to preserve facial nerve function. This thin layer of perineurium arising from the vestibular nerves is used as a protective buffer to shield the facial and cochlear nerves from direct microdissection trauma. A near-total resection was achieved, and the patient had an immediate postoperative House-Brackmann grade I facial nerve function. The operative nuances and pearls of technique for safe cranial nerve and brainstem dissection, as well as the intraoperative decision and technique to leave the least amount of residual adherent tumor, are demonstrated. The video can be found here: https://stream.cadmore.media/r10.3171/2021.7.FOCVID21128.
在这段演示视频中，作者展示了使用神经外膜下解剖技术对巨大囊性前庭神经鞘瘤进行乙状窦后切除术，以保留面神经功能。源自前庭神经的这层薄神经外膜被用作保护缓冲层，使面神经和蜗神经免受直接显微解剖创伤。实现了近全切除，患者术后即刻面神经功能为House-Brackmann I级。展示了安全进行颅神经和脑干解剖的手术细微差别及技术要点，以及术中关于残留粘连肿瘤最少化的决策和技术。视频可在此处查看：https://stream.cadmore.media/r10.3171/2021.7.FOCVID21128 。
