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目的总结53例大型听神经瘤患者显微切除术后近、远期疗效,探讨手术中、术后如何最大可能的保存面神经功能。方法我们对1995～2005年收治的53例大型听神经瘤患者从切口设计、分离方法、术后管理等多方面采取改进措施,提高治疗质量,术后患者进行6个月至10年以上随访,观察面神经功能恢复的情况。结果53例全部解剖保存了面神经;术后除部分患者不同程度面瘫外无明显其它手术直接并发症;经6个月至10年以上随访,48例患者面神经功能有不同程度的恢复,18例恢复至基本正常。结论即使是大型听神经瘤,只要手术方法适合,术后管理得当,面神经功能保存也是可能的。
Objective To summarize the short-term and long-term effects of microsurgical resection in 53 patients with large acoustic neuroma and to explore how to preserve the facial nerve functions during and after surgery. Methods 53 cases of large acoustic neuroma admitted to our hospital from 1995 to 2005 were improved from the aspects of incision design, method of separation and postoperative management to improve the quality of treatment. The patients were followed up for 6 months to more than 10 years after operation Facial nerve function recovery situation. Results All the 53 cases had facial nerve preserved completely. There were no direct complication of other operations except some patients with facial paralysis after operation. After 6 months to more than 10 years follow-up, facial nerve function of 48 cases recovered to some extent, and 18 cases recovered To basic normal. Conclusions Even with large acoustic neuromas, facial nerve function preservation is possible as long as the method of operation is appropriate and the postoperative management is appropriate.