摘要
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.
出版日期
2015年06月16日（中国期刊网平台首次上网日期，不代表论文的发表时间）
