Samii M
Neurosurgery Department, Hannover, Germany.
Br J Neurosurg. 1995;9(3):413-24. doi: 10.1080/02688699550041412.
Bilateral acoustic neurinomas are found in almost all patients with neurofibromatosis 2 (NF2). With better knowledge of the disease and development of diagnostic procedures, an increasing number of patients have been detected at an early stage of the disease. Preservation of hearing in these cases has become more feasible. Between 1979 and 1992, 110 acoustic neurinomas in 74 NF2 patients have been resected in this department. All tumours but 11 were completely removed. In 11 cases deliberate subtotal tumour removal was performed: bilaterally in one deaf patient for brainstem decompression, and unilaterally in nine patients with the aim of hearing preservation. In seven of these nine cases hearing was preserved. The total rate of hearing preservation was 36%. Considering only those patients with good preoperative hearing and small tumours, the rate of hearing preservation was 58%. Facial nerve preservation was 92%. Nerve reconstructions were performed in cases of facial nerve damage, with good results in most of the cases. The importance of early detection of the disease and early removal of tumours is stressed. Surgical decision making based on the author's personal experience in dealing with these cases is discussed, and some cases are illustrated.
几乎所有2型神经纤维瘤病（NF2）患者都存在双侧听神经瘤。随着对该疾病的了解增多以及诊断方法的发展，越来越多的患者在疾病早期被发现。在这些病例中保留听力变得更加可行。1979年至1992年间，该科室对74例NF2患者的110个听神经瘤进行了切除。除11个肿瘤外，其余所有肿瘤均被完全切除。在11例病例中进行了有意识的次全肿瘤切除：在1例失聪患者中双侧进行以行脑干减压，在9例患者中单侧进行以保留听力。在这9例中的7例中听力得以保留。听力保留的总率为36%。仅考虑那些术前听力良好且肿瘤较小的患者，听力保留率为58%。面神经保留率为92%。对面神经损伤的病例进行了神经重建，大多数病例效果良好。强调了疾病早期检测和肿瘤早期切除的重要性。讨论了基于作者处理这些病例的个人经验的手术决策，并举例说明了一些病例。
