Smith M F, Clancy T P, Lang J S
Trans Sect Otolaryngol Am Acad Ophthalmol Otolaryngol. 1977 Jul-Aug;84(4 Pt 1):ORL-704-9.
Conservation of hearing in acoustic neurilemmoma surgery is possible by the suboccipital route. The hearing preservation prognosis decreases as the size of the cerebellopontine angle neoplasm increases. Von Recklinghausen disease spells a poor prognosis for hearing. Some hearing was retained in seven of ten patients with preoperative hearing. Three patients retained postoperative hearing levels and speech sound discrimination equal to preoperative levels. One patient had a progressive high-frequency sensorineural hearing loss in the nontumor ear and was fitted with a hearing aid for the postoperative ear; he now has successful binaural hearing function. Gentle technique, microhemostasis, special instrumentation, and well-developed surgical craft are essential for preserving the microstructures necessary for hearing. Furthermore, the suboccipital approach for neurilemmomas less than 2 cm gives good surgical exposure and a reasonable chance to save hearing.
通过枕下途径在听神经鞘瘤手术中保留听力是可行的。随着小脑脑桥角肿瘤大小的增加，听力保留预后会降低。冯·雷克林霍增氏病预示着听力预后不良。10例术前有听力的患者中有7例保留了部分听力。3例患者术后听力水平和语音辨别能力与术前相当。1例患者非肿瘤耳出现进行性高频感音神经性听力损失，术后耳佩戴了助听器；他现在双耳听力功能良好。轻柔的技术、微止血、特殊器械和成熟的手术技巧对于保留听力所需的微观结构至关重要。此外，对于小于2 cm的神经鞘瘤采用枕下入路可获得良好的手术视野并有合理的机会挽救听力。
