Cohen N L
Laryngoscope. 1979 Jun;89(6 Pt 1):886-96. doi: 10.1288/00005537-197906000-00004.
A review is presented of 34 cerebellopontine angle tumors surgically removed between 1973 and 1978 by the author at the New York University Medical Center. A diagnostic protocol is outlined: An acoustic PEG (small volume pneumoencephalogram with polytomography) is utilized where a medium to large tumor is suspected, and a Pantopaque fossagram for the smaller tumors. Indications are given for the middle fossa, translabyrinthine and suboccipital approaches, depending on tumor size and level of hearing. Hearing was successfully preserved at or near the preoperative level in 3 of 6 extracanalicular tumors operated upon using the suboccipital microsurgical approach. Audiometric data are given, demonstrating the preservation of hearing. The surgical technique is described. There were no fatalities in the entire series. The incidence of permanent facial nerve palsy was 8%. Nerve palsy occurred in large tumors only.
本文回顾了作者于1973年至1978年在纽约大学医学中心手术切除的34例桥小脑角肿瘤。概述了诊断方案：怀疑为中至大型肿瘤时采用声学PEG（小容量气脑造影加断层摄影），较小肿瘤采用碘苯酯脑池造影。根据肿瘤大小和听力水平，给出了中颅窝、经迷路和枕下入路的适应证。在采用枕下显微手术入路的6例耳道外肿瘤中，有3例成功保留了术前或接近术前水平的听力。给出了听力测定数据，证明了听力的保留情况。描述了手术技术。整个系列中无死亡病例。永久性面神经麻痹的发生率为8%。面神经麻痹仅发生在大型肿瘤中。
