Leclercq T A, Hill C L, Grisoli F
Laryngoscope. 1980 Jun;90(6 Pt 1):1011-7. doi: 10.1002/lary.1980.90.6.1011.
In our series of 10 patients, the age ranged between 31 and 69 years. Seven patients were followed for from 1-2 1/2 years. Complaints consisted of tinnitus, vertigo, or both. Vegatative symptoms consisting of nausea or vomiting were minimal or absent. Audiometry revealed a varying neurosensory loss. Vestibular hypoexcitability was a common finding. Good discrimination appeared to indicate a vascular loop rather than hydrops. The neuroradiological work-up was unremarkable. Treatment consisted of neurovascular decompression of the VIIth nerve by microdissection. The approach used was a retromastoid incision with a bony removal limited to 20 mm. Cerebrospinal fluid withdrawal and lateral decubitus positioning permitted visualization of the VIIIth nerve without retraction of the cerebellum. Lack of bleeding, rapidity of procedure and benign postoperative course are emphasized. The results on tinnitus and vertigo were satisfactory. No additional deficit was created by surgery. If the symptoms are significantly disabling, microsurgical exploration is indicated.
在我们的10例患者系列中，年龄在31岁至69岁之间。7例患者随访了1至2年半。症状包括耳鸣、眩晕或两者皆有。由恶心或呕吐组成的自主神经症状轻微或不存在。听力测定显示出不同程度的神经感觉性听力损失。前庭兴奋性降低是常见表现。良好的辨别力似乎表明是血管襻而非积水。神经放射学检查无明显异常。治疗包括通过显微解剖对第VII神经进行神经血管减压。采用的手术入路是乳突后切口，骨质切除限于20毫米。脑脊液引流和侧卧位可在不牵拉小脑的情况下显露第VIII神经。强调手术中无出血、手术迅速以及术后病程良好。耳鸣和眩晕的治疗结果令人满意。手术未造成额外的功能缺损。如果症状严重致残，则需进行显微手术探查。
