Pellet W, Cannoni M, Pech A
Neurochirurgie. 1979;25(2):84-90.
The authors, supporters of a tight oto-neuro-surgical collaboration, show their tactical evolution in front of acoustic neurinomas which they operated at first in two stages, trans-labyrinthine then sub-occipital, and now they approach only by trans-labyrinthine way. They report their experience and their results to the point of a first serie of 30 cases : 10 combined approaches in two stages, and 20 trans-labyrinthine approaches. The mortality (3 cases-10%) for this first serie is still raised. One patient, after a softening of the pons, maintained important sequelles. On the other hand, among the remaining 26 patients, 13 kept a normal facial motricity and 5 recovered but with syncinesis. These first results are still perfectible : among the 20 last cases only trans-labyrinthine approached the facial nerve preservation was realised in 72% of the cases. The most frequent surgical complication is a cerebro-spinal fluid leak (7 cases) which fortunately the most often spontaneously dry up (6 cases) but which justify a very attentive closure technic. The authors show the arguments which convinced them of the interest of the trans-labyrinthine approach such it is done by W. House.
作为紧密的耳神经外科协作的支持者，作者展示了他们在听神经瘤手术方面的策略演变。他们最初对听神经瘤采用两阶段手术，先经迷路后经枕下，而现在仅采用经迷路入路。他们报告了自己的经验和结果，直至首个30例的系列病例：10例两阶段联合入路，20例经迷路入路。该首个系列病例的死亡率（3例 - 10%）仍然较高。一名患者在脑桥软化后遗留严重后遗症。另一方面，在其余26名患者中，13名患者面部运动功能正常，5名患者恢复但存在联带运动。这些初步结果仍有待完善：在最后20例仅采用经迷路入路的病例中，72%的病例实现了面神经保留。最常见的手术并发症是脑脊液漏（7例），幸运的是大多数（6例）可自行愈合，但这证明了需要非常精细的封闭技术。作者展示了使他们确信W. 豪斯所采用的经迷路入路具有优势的论据。
