NeurosurgicalProcedures神经外科手术CN教程.ppt

Craniomaxillofacial Craniomaxillofacial Neurosurgical Procedures 神经外科手术 Acoustic Neuroma听神经瘤 Aneurysm动脉瘤 Arteriovenous Malformation (AVM)动静脉畸形（AVM) Chiari Malformation小脑扁桃体下疝畸形 Deep Brain Stimulation深部脑刺激 Epilepsy癫痫 Frontal Bone Contouring重塑前额成形术 Meningioma Removal脑膜瘤切除术 Microvascular Decompression (MVD)微血管减压术（MVD） Pituitary Tumor Removal垂体肿瘤切除术 Cases病例 Acoustic Neuroma听神经瘤 Condition:条件： An acoustic neuroma is a benign, slow-growing tumor that arises from the covering of the vestibulocochlear nerve.听神经瘤是一种由于前庭耳蜗神经被遮盖引起的良性、生长缓慢的肿瘤。 As the tumor grows it can expand into the area between the brainstem and temporal bone随着听神经瘤的扩散，它可以扩展到脑干和颞骨之间的区域。 The tumor can compress the trigeminal nerve causing loss of facial sensation and can also compress the brainstem. 肿瘤可压迫三叉神经，从而造成面部感觉丧失，也可以压迫脑干。 Overview:概述： An acoustic neuroma is a tumor that grows on the nerves responsible for balance and hearing. Although the tumor is typically benign, they can cause gradual hearing loss, ringing in the ear, and dizziness. If surgery is required, there are three approaches the surgeon can take to expose the tumor:听神经瘤是一种生长在神经上的影响大脑的平衡和听觉作用的肿瘤。虽然听神经瘤通常都是良性肿瘤，但是它们也可以导致渐进性听力损失、耳鸣和头晕。如果需要手术的话，外科医生可以采取三种入路方式摘除肿瘤： Middle Fossa经中颅窝手术入路 Suboccipital经枕骨下手术入路 Translabyrinthine经迷路手术入路 经中颅窝穿颅术 经枕骨下穿颅术 经迷路穿颅术 Acoustic Neuroma听神经瘤 Surgery: 外科手术： Surgical removal is the most common treatment and especially with large tumors. The prioritites the surgeon has when conducting surgery are: preserving the facial nerve, preserving useful hearing in the affected ear, and complete tumor removal. Complete tumor removal carries a higher risk of hearing loss. The approach to the surgery is based off of tumor size, position and the hearing status of the patient. 手术切除是最常用的治疗方式，特别是针对较大的肿瘤。外科医生进行手术时要优先考虑：保护面神经；尽量保留受影响耳朵的听觉，切除全部肿瘤。全部肿瘤的切除具有高风险性，可能引起听力受损。手术方法根据肿瘤大小，位置和患者的听力状况决定。 Suboccipital (retrosigmoid): craniotomy made behind the ear, exposing the bone overlying the in