[1]成宜军,张玉海,邹元杰,等.面神经监测下切除大型听神经瘤[J].临床神经外科杂志,2014,(02):110-115.
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面神经监测下切除大型听神经瘤()
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《临床神经外科杂志》[ISSN:1672-7770/CN:32-1727/R]

卷:
期数:
2014年02期
页码:
110-115
栏目:
论著
出版日期:
2014-04-30

文章信息/Info

Title:
Resection of Large Vestibular Schwannomas under Facial Nerve Monitoring
作者:
成宜军 张玉海 邹元杰 张锐 章文斌 肖朝勇 刘文 刘翔 吕著海 刘宏毅
南京医科大学附属南京脑科医院
关键词:
大型听神经瘤面神经肌电图术中神经电生理监测显微神经外科
Keywords:
large vestibular schwannomafacial nerveelectromyography intraoperative neurophysiological monitoring microneurosurgery
分类号:
R739.41
文献标志码:
A
摘要:
目的 探讨面神经监测下切除大型听神经瘤的技巧。方法 22例大型听神经瘤,在面神经监测下行显微手术切除,术后随访面神经功能。结果 22例听神经瘤全切除15例,次全切除7例。面神经自发肌电图在面神经受牵拉、挤压、生理盐水冲洗等操作过程中产生显著放电,刺激肌电图对于寻找和辨认面神经具有重要作用。所有病例面神经均解剖保留。术后随访6-42个月,面神经功能(House-Brackmann分级)I级11例,II级5例,III级2例,IV级4例。结论 娴熟的手术技术和面神经监测技术对术中解剖与功能保留面神经具有重要价值。
Abstract:
Objective To explore the techniques for resection of large vestibular schwannomas under facial nerve monitoring. Methods A retrospective study of 22 cases with large vestibular schwannomas was performed. All the tumors were microsurgically resected under facial nerve monitoring. The cases were followed up and facial nerve function was evaluated in each case. Results Gross total resection was achieved in 15 and subtotal in 7. Free-running facial nerve electromyography was elicited while retraction or compressing the FN or irrigating. Stimulated electromyography was helpful for tracking and identifying the facial nerve. Anatomical preservation of facial nerve was achieved in all cases. At the follow-up of 6-42 months posteratively, facial nerve function was HB grade I in 11 cases, grade II in 5 cases, grade III in 2 cases and grade IV in 4 cases. Conclusion Sophisticated surgical skills and facial nerve monitoring are contributive to preservation of anatomical and functional integrity of facial nerve.

相似文献/References:

[1]刘宏毅,张玉海,邹元杰,等.弥散张量面神经成像技术在大型听神经瘤术中面神经定位的可行性研究[J].临床神经外科杂志,2015,(01):36.
[2]陈曦,蒋伟超,孙金莉,等.大型听神经瘤手术中面神经的保护研究[J].临床神经外科杂志,2019,16(4):319.[doi:10.3969/j.issn.1672-7770.2019.04.009]
 CHEN Xi,JIANG Wei-chao,SUN Jin-li,et al.Facial nerve reservation in large acoustic neuroma surgery[J].Journal of Clinical Neurosurgery,2019,16(02):319.[doi:10.3969/j.issn.1672-7770.2019.04.009]

备注/Memo

备注/Memo:
[收稿日期] 2013-05-12 [基金项目] 江苏省临床医学科技专项基金
更新日期/Last Update: 2014-04-15