Brookes G B, Woo J
National Hospital for Neurology and Neurosurgery, London, UK.
Clin Otolaryngol Allied Sci. 1994 Jun;19(3):204-14. doi: 10.1111/j.1365-2273.1994.tb01216.x.
Hearing conservation in acoustic tumour surgery remains controversial. There have been few previous reports in the British literature. The senior author has managed 24 patients by retrosigmoid surgery with the intention of preserving hearing during the last 9 years. The clinical features, surgical technique and results are discussed with respect to pre-operative selection criteria, and post-operative quality of hearing. Hearing preservation has been achieved in 11 (78.6%) of 14 patients with small or intracanalicular tumours and a mean minimum auditory threshold of 35 dB and 70% speech discrimination, the majority (81.8%) above the 50 dB/50% level. Tumour filing the fundus of the internal auditory canal was found to be a significant adverse prognostic factor as regards successful hearing preservation. Tumour excision was complete in all patients. Nearly 90% of patients had normal facial function, and the remaining 10% grade II function. Associated morbidity was minimal. It is suggested that the potential for hearing conservation should be considered as a factor in the management of patients with small acoustic neuromas.
听神经瘤手术中的听力保留仍存在争议。英国文献中此前的相关报道较少。资深作者在过去9年中通过乙状窦后手术治疗了24例患者，旨在保留听力。本文就术前选择标准和术后听力质量，对临床特征、手术技术及结果进行了讨论。14例小型或内听道内肿瘤患者中，11例（78.6%）实现了听力保留，平均最低听阈为35dB，言语识别率为70%，大多数（81.8%）高于50dB/50%的水平。发现内听道底部被肿瘤填满是听力保留成功与否的一个重要不良预后因素。所有患者的肿瘤均被完整切除。近90%的患者面部功能正常，其余10%为二级功能。相关并发症极少。建议在小型听神经瘤患者的治疗中，应将听力保留的可能性作为一个考虑因素。
