迷路后入路在桥小脑角区手术中的应用.docVIP

迷路后入路在桥小脑角区手术中的应用 杨洁 朱伟栋 柴永川 贾欢 汪照炎 吴皓 a上海交通大学医学院耳科学研究所上海耳鼻疾病 人民医院耳鼻咽喉头颈外科 摘要： 目的探讨迷路后入路在桥小脑角区手术中的应用方法和临床价值。方法冋顾分 析上海交通大学医学院耳科学研究所2011-01-012016-01-01收治的42例桥小脑 角区疾病患者，均采用迷路后入路暴露手术区域，术中应用显微镜-内镜双镜联 合技术。结果所有病例均成功手术。听神经瘤及胆脂瘤病例均完全切除，术后 可测听力保留率(AAO-HNS听力评级A、B、C级)为66. 7% (6/9),术后面神经 功能良好(HB分级卜II级)，无1例患者岀现脑脊液漏等颅脑并发症，随访中 未见复发。颅神经疾病术后症状均消失，术后均保留可测听力，面神经功能良好, 术后无后组颅神经等非责任神经并发症。结论迷路后入路创伤较小，听觉及而 神经功能保留率高，在内镜辅助下特别适合功能性颅神经手术及位于内耳道口 1直径〈15 mm的桥小脑角听神经瘤及胆脂瘤的治疗。 关键词： 小脑脑桥角；神经瘤，听;迷路后入路;显微镜-内镜双镜联合技术; 作者简介：杨洁，女，安徽人，在读博士研究生，研究方向为耳科学。 Email:drjieyang@163. com 作者简介：吴皓(Emai 1: wuhao622@s i na. on) 收稿日期：2017-04-12 基金:国家自然科学基金面上项目 和国家自然科学基金青年项目联合资助 Retrolabyrinthine approach for cerebellopontine angle region surgeries YANG Jie ZHU Wei dong CHAI Yongchuan JIA Htmn WANG Zhaoyan WU Hao Department of Otolaryngology Head and Neck Surgery, Shanghai Xinhua Hospital, Shanghai Jiaotong University School of Medicine; Ear Institute, Shanghai Jiaotong University School of Medicine, Shanghai Key Laboratory of Transittional Medicine on Ear and Nose diseases, Shanghai; Abstract： OBJECTIVE To evaluate the application of retrolabyrinthine approach in cerebellopontine angel (CPA) region surgeries. METHODS A total of 42 patients underwent microscopic-endoscopic cooperative surgeries for CPA lesions via retrolabytinthine approach were reviewed. They were hospitalized from January 1 st 2011 to January 1 st 2016 in our institution. The microscopiccndoscopic technique was applied in all surgeries. RESULTS Complete removal was obtained in all tumor resections and satisfactory symptom-relief was achieved in all microvascular decompressions and neurectomies. In cases with acoustic neuroma and cholesteatoma, useful hearing (AA0H1NS classes A, B and C) was obteiined in 66. 7% (6/9) patients. No facial paralysis and postoperative complications such as cerebrospinal fluid leakage occurred during follow-up. In cranial nerve rhizopathies cases, complete relief was achieved in