学科分类
/ 1
1 个结果
  • 简介:OBJECTIVETheaimofthisanalysiswastoassessshort-termandlong-termoutcomeswithrespecttothepreservationoffacialandauditorynervefunctionfollowingsurgeryforsporadicvestibularsehwannomas.MATERIALANDMETHODSThestudyincluded220consecutivepatientsoperatedonwiththeretrosigmoid(217)ortranslabyrinthine(3)approach.Themeanextrameataldiameterofthetumorwas30mm.In217patients,grosstotalresectionwasperformedandnear-totalin3.Beforesurgery,thefacialnerve(CNVII)weaknesswasfoundin18%ofpatientsandonly20%hadserviceablehearing.IntraoperativeneurophysiologicalCNVIImonitoringwasroutinelyused(thelast211procedures).Intraoperativemonitoringofthecochlearnervefunctionwasusedwhenthepreservationofhearingwasattempted(45procedures).RESULTSTherateofCNVIIcontinuitylossduringsurgerywas11%,however,thisdecreasedto6%inthesecondhalfoftheseries.Facialnervefunctiondeteriorated,in88%ofthepatientsshortlyaftersurgery.However,itimprovedin87%infollow-up.DelayedCNVIIpalsywasfoundin5%ofthepatientsandhadagoodprognosisin88%.FinalsatisfactoryCNVIIfunction(CNVII-SF,HBgradesⅠ-Ⅲ)wasachievedin76%ofthepatientswhenexcludingtheanastomosisresults,and87%whenincludingthem.Inrecentyears,therateofCNVII-SFhasrisento94%.Non-serviceablehearingwaspreservedin49%ofthepatients,onwhomitwasattempted.CONCLUSIONConsideringthesizeofthetumorsandextentoftheresections,thepreservationofCNVIIfunctioniscurrentlyveryhigh.AclosesurveillanceofCNVIIfunctionevolutionfollowingsurgeryismandatory,as2/3ofthepatientsdischargedwithdeepparesiswillneeddifferentfacereanimationprocedures.Thepreservationofusefulhearingisstillproblematic,especiallyinpatientswithlargetumor.

  • 标签: 神经外科疾病 临床 治疗 诊断