Ruiz-Fornells A, Moñux A, Cabra J, Gavilán J
Universidad Autónoma, Madrid.
Acta Otorrinolaringol Esp. 1996 May-Jun;47(3):205-7.
Our 24-year experience with acoustic neuroma surgery is reported. Three approaches were used in 34 patients: translabyrinthine (11 cases), transtemporal (2 cases), and retrosigmoid (21 cases). Prolonged facial paralysis occurred in 27% of patients with the translabyrinthine approach and in 15% with the retrosigmoid approach. Facial nerve monitoring was used in all operations with the retrosigmoid approach. In the translabyrinthine approach, 5 patients had CSF leak, 2 required secondary surgery, and 2 developed meningitis. With the retrosigmoid approach, 5 patients had CSF leak, 2 required secondary surgery, 3 developed meningitis (1 died), and 1 patient required emergency reoperation for posterior cranial fossa hematoma. Auditory function was preserved in one patient. The advantages of the retrosigmoid approach have become apparent: good exposure, speed, and preservation of the facial and cochlear nerves.
报告了我们在听神经瘤手术方面24年的经验。34例患者采用了三种手术入路：经迷路入路（11例）、经颞入路（2例）和乙状窦后入路（21例）。经迷路入路的患者中有27%发生了长期面瘫，乙状窦后入路的患者中有15%发生了长期面瘫。所有乙状窦后入路手术均使用面神经监测。经迷路入路中，5例患者发生脑脊液漏，2例需要二次手术，2例发生脑膜炎。采用乙状窦后入路时，5例患者发生脑脊液漏，2例需要二次手术，3例发生脑膜炎（1例死亡），1例患者因后颅窝血肿需要紧急再次手术。1例患者保留了听觉功能。乙状窦后入路的优点已很明显：暴露良好、速度快以及能保留面神经和蜗神经。
