【摘要】 报告作者在30年中施行的240例直径>4cm的听神经瘤的手术结果。其中159例用肉眼进行手术,81例用手术显微镜。肉眼组的肿瘤全切除率83.6％,死亡率6.3％;显微组均获肿瘤全切除,无死亡。此外70例(86.4％)解剖保留面神经,53例(65.4％)功能保留,在有听力残留的患者中15例(65.2％)保留听力。167侧面神经离断的病人中,81例进行了面副神经吻合,95.1％吻合成功。5例面神经离断而残端长度足够者行颅内面神经端端吻合,面肌功能均获恢复。全组141例获随访(0.5～19年),60.3％还能工作(均属肿瘤全切除病人)。更多还原

【Abstract】 The results of surgical removal of giant acoustic neuromas (more than 4 cm in diameter) in 240 cases performed by author, self in the past 30 years have been reported. Of the 240 cases. 159 patients were operated on without aid of operating microscope at the initial phase of the series. Complete removal of he tumor was achieved in 133 cases (83.6%) in this naked eye group and 10 patients died. The surgical microscope was used during acoustic tumor surgery in the remaining 81 cases in the recent years.All patients in the microsurgical group underwent total tumor removal and no patient died. In addition, anatomical continuity of the facial nerve was preserved in 70 patients (86.4%) in the microsurgical group. The postoperative follow-up examination showed preservation of the facial nerve function in 53 cases(65.4%)and the hearing acuity in 15 cases(65.2%) on the affected side in the microsurficat group, of the 167 patients whose acoustic nerve were cut during operation for tumor removal, facial-accessorius anastomosis was peaformed in 81 cases and the ansto-mosis was successful in 70 cases (95.196). Intra-cranial end-to-end anastomosis of the facial nerve was performed in 5 patients whose facial nerve were transected and the residual ends of the nerve were long enough.All of the 5 patients regained the facial更多还原