面听神经根压迫综合征48例.docVIP

面听神经根压迫综合征48例 目录 TOC \o 1-9 \h \z \u 目录 1 正文 1 文1：面听神经根压迫综合征48例 1 1 资料与方法 2 2 结果 3 3 讨论 4 文2：桥小脑角肿瘤手术中面听神经的保护 5 1资料与方法 5 参考文摘引言： 8 原创性声明（模板） 9 文章致谢（模板） 9 正文 面听神经根压迫综合征48例 文1：面听神经根压迫综合征48例 Abstract： Objective To summarize the 48 reports of the patients with auditory and cranial nerve root compression and research the causes of the Cerebellopontine angle was reached via retrosigmoid approach. The auditory and cranial nerve root was carefully checked so that the causes could be found. Microvascular decompression (MVD), adherence splitting and cranial nerve combing were performed to different niduses under The auditory and cranial nerve roots were found to be oppressed by primary blood vessels in all the patients, 16 of whom were accompanied with arachnoid thickening and adhesion. All the patients were operated successfully and discharged. Tinnitus recurred in two patients and mimetic convulsion recurred in four ones according to 1-15 yea, followup, but they were ameliorated after operation. Conclusion The main etiological factor of auditory and cranial nerve compression syndrome is oppression of primary blood vessel as to the 48 patients. Some ones suffer from additional arachnoid thickening and adhesion. Key words： auditory and cranial nerve; primary blood vessel oppression; syndrome 1990年6月—2006年3月，经乙状窦后入路，桥小脑角显微手术828例，其中面听神经根探查、微血管减压及梳理术治疗面听神经根压迫综合征48例，效果满意，现报告如下。2007年12月 第35卷 第6期临 床 军 医 杂 志 (Clin J Med Offic) 1 资料与方法 一般资料 面听神经压迫综合征48例，男18例，女30例；年龄22~78岁，平均岁；病史2~40年，平均年；左侧25例，右侧21例，双侧2例。临床表现为在同一侧既有面肌痉挛(简称HFS)的症状体征，又有与颈动脉和心脏搏动相一致的节律性耳鸣，部分病人伴有不同程度的眩晕及 听力 减退等症状，压迫同侧颈动脉时耳鸣症状可明显减轻或消失，长期非手术治疗效果不佳。 手术方法 患者平卧位头抬高15°，略偏向健侧，在局麻下于患侧乳突后中下部作一长宽约4 cm×3 cm 之“U”形切口，一次性切开皮肤、皮下组织、肌肉及骨膜。用骨膜剥离子沿颅骨壁依次向前剥离，并将该“U”形骨膜肌皮瓣向前翻转固定，用开颅钻在乙状窦后缘与横窦下缘夹角处钻开一直径约2 cm 之骨窗，“U”形切开硬脑膜并向前翻起，在20%甘露醇降脑压情况下，用微型脑压板轻轻将小脑向后上方牵引，沿小脑天幕向前达内耳门处，在手术显微镜下仔细检查听神经表面及周围，在听神经与岩静脉间切开桥池蛛网膜，放出脑脊液，在听神经腹内侧探查面神经根及周围情况，将面听神经根周围的粘连病灶分解开，并将压迫于面听神经上的责任血管游离推移开，再用显微神经拉钩在听神经腹内侧将面神经勾起，沿面神经颅内段长轴作纵行梳理6~8