[Our approach to the treatment of vestibular schwannomas with arachnoid dissection of the facial nerve].

Q4 Medicine
I M Alekseev, V A Ovchinnikov, S M Chupalenkov, A A Zuev
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引用次数: 0

Abstract

Preserving the function of the facial nerve is extremely important in surgery for vestibular schwannomas. Two methods of arachnoid dissection are described for resection of vestibular schwannoma via retrosigmoid approach (from the brain stem and internal auditory canal).

Objective: To evaluate the results of arachnoid dissection of the facial nerve from internal auditory canal when resecting the vestibular schwannoma.

Material and methods: We analyzed 61 patients with vestibular schwannomas. Patients were divided into 2 groups depending on surgical technique. We estimated facial nerve function before and after surgery, preoperative dimension of vestibular schwannoma and extent of resection. The influence of various factors on extent of resection and postoperative facial nerve function was studied.

Results: Vestibular schwannoma resection from the brain stem was performed in 30 patients, arachnoid dissection - in 31 patients. There was no significant between-group difference. Gross total resection was performed in 78.7% of cases. Both techniques demonstrated similar results regarding extent of resection. Arachnoid dissection showed the advantage regarding facial nerve function immediately after surgery (p=0.012) and 6 months later (p<0.001). Normal facial nerve function in 6 months after arachnoid dissection was observed in 80.7% of patients. Preoperative dimension of tumor influenced facial nerve function in addition to technique of resection (p=0.001).

Conclusion: We identified the factors influencing facial nerve function after resection of vestibular schwannoma. Surgical technique was the most significant factor. These data expand and popularize arachnoid dissection in surgery of vestibular schwannomas.

[我们用面神经蛛网膜剥离术治疗前庭分裂瘤的方法]。
在前庭分裂瘤手术中,保留面神经的功能极为重要。本文介绍了通过蛛网膜后入路(从脑干和内听道入路)切除前庭裂管瘤的两种蛛网膜剥离方法:评估在切除前庭分裂瘤时从内听道进行面神经蛛网膜剥离的效果:我们分析了61例前庭裂孔瘤患者。根据手术方法将患者分为两组。我们估计了手术前后的面神经功能、前庭分裂瘤的术前尺寸和切除范围。研究了各种因素对切除范围和术后面神经功能的影响:结果:30 名患者进行了脑干前庭裂孔瘤切除术,31 名患者进行了蛛网膜切除术。组间差异不明显。78.7%的病例进行了全切。两种技术在切除范围上的结果相似。蛛网膜切除术在术后即刻(p=0.012)和6个月后(pp=0.001)的面神经功能方面显示出优势:我们确定了影响前庭裂孔瘤切除术后面神经功能的因素。结论:我们确定了影响前庭分裂瘤切除术后面神经功能的因素,其中手术技术是最重要的因素。这些数据扩大并推广了蛛网膜剥离术在前庭分裂瘤手术中的应用。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
0.70
自引率
0.00%
发文量
75
期刊介绍: Scientific and practical peer-reviewed journal. This publication covers the theoretical, practical and organizational problems of modern neurosurgery, the latest advances in the treatment of various diseases of the central and peripheral nervous system. Founded in 1937. English version of the journal translates from Russian version since #1/2013.
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