Microsurgical excision of large acoustic neurinoma via suboccipital retrosigmoid keyhole approach
10.3760/cma.j.issn.1671-8925.2010.11.015
- VernacularTitle:枕下乙状窦后锁孔入路显微手术切除大型听神经鞘瘤
- Author:
Guo-Wei TAN
1
;
Zhan-Xiang WANG
;
Jian-Feng GUO
;
Si-Fang CHEN
;
Hong-Wei ZHU
;
Yong-Hui MA
Author Information
1. 厦门大学附属第一医院
- Keywords:
Neuroma,acoustic;
Suboccipital retrosigmoid;
Keyhole approach;
Microsurgery
- From:
Chinese Journal of Neuromedicine
2010;09(12):1243-1245
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the surgical skills and efficacy of microsurgical excision of large acoustic neurinoma via the suboccipital retrosigmoid keyhole approach. Methods Fifty-nine patients with large acoustic neurinoma (≥3 cm) underwent microsurgical resection via suboccipital retrosigrmoid keyhole approach. The intraoperative position of the operative bed and angle of the microscope were adjusted to expose the tumors sufficiently. The duramater was sutured tightly and the bone flap was replaced and fixed. Results Of the 59 patients, 53 (89.8%) received a total resection of the tumors, and 6 (10.2%) subtotal resection. No patient died. The facial nerve was anatomically preserved in all the patients. Forty-five patients (76.3%) suffered from mild or moderate facial palsy after the surgery, and the symptoms were improved significantly after expectant treatment. Fifteen patients preserved partial hearing. No subcutaneous water accumulation or cerebrospinal fluid leakage occurred.Conclusion Microsurgery via suboccipital retrosigmoid keyhole approach is a favorable treatment for large acoustic neurinomas with low morbidity and mortality,which can effectively protect the function of the acoustic and facial nerves.
