Glasscock M E, Hays J W, Minor L B, Haynes D S, Carrasco V N
Department of Neurosurgery, Vanderbilt University, Nashville, Tennessee.
J Neurosurg. 1993 Jun;78(6):864-70. doi: 10.3171/jns.1993.78.6.0864.
Preservation of hearing was attempted in 161 cases of histologically confirmed acoustic neuroma removed by the senior author between January 1, 1970, and September 30, 1991. There were 136 patients with unilateral tumors; 22 patients had bilateral tumors (neurofibromatosis 2) and underwent a total of 25 procedures. Hearing was initially preserved in 35% of patients with unilateral tumors and in 44% of those with bilateral tumors. Results are reported in terms of pre- and postoperative pure tone average and speech discrimination scores. Surgical access to the tumor was obtained via middle cranial fossa and suboccipital approaches. The latter has been used more often over the past 5 years because of a lower associated incidence of transient facial paresis. Persistent postoperative headaches have been the most common complication following the suboccipital approach. The results of preoperative brain-stem auditory evoked response (BAER) studies were useful in predicting the outcome of hearing preservation attempts. Patients with intact BAER waveform morphology and normal or delayed latencies had a higher probability of hearing preservation in comparison to those with abnormal preoperative BAER morphology.
1970年1月1日至1991年9月30日期间，资深作者对161例经组织学确诊的听神经瘤患者进行了听力保留尝试。其中136例患者为单侧肿瘤；22例患者患有双侧肿瘤（神经纤维瘤病2型），共接受了25次手术。单侧肿瘤患者中，35%的患者听力最初得以保留；双侧肿瘤患者中，这一比例为44%。结果以术前和术后纯音平均听阈及言语识别率评分报告。通过中颅窝和枕下入路切除肿瘤。由于枕下入路相关的短暂性面瘫发生率较低，在过去5年中使用更为频繁。持续性术后头痛是枕下入路术后最常见的并发症。术前脑干听觉诱发电位（BAER）研究结果有助于预测听力保留尝试的结果。与术前BAER形态异常的患者相比，BAER波形形态完整且潜伏期正常或延迟的患者听力保留的可能性更高。
